Epidural Analgesia for Treatment of a Sickle Cell Crisis During Pregnancy

Winder AD, Johnson S, Murphy J, Ehsanipoor RM. Epidural analgesia for treatment of a sickle cell crisis during pregnancy. Obstet Gynecol. 2011 Aug;118(2 Pt 2):495-497. doi: 10.1097/AOG.0b013e3182267e58. PMID: 21768865.

Background
More than 50% of obstetric patients with sickle cell disease will have a pain crisis during pregnancy, and the management of these cases can be challenging.

Case
A 20-year-old African American with sickle cell disease presented at 29 4/7 weeks of gestation with severe, debilitating leg and back pain. Large doses of intravenous narcotics did not result in significant pain relief, so a lumbar epidural was placed. This resulted in complete pain relief within several minutes. The patient’s symptoms resolved over several days and after a short course of narcotics she was discharged to home, and the remainder of her pregnancy was uncomplicated.

Conclusion
Epidural anesthesia should be considered as a potentially effective treatment for a severe sickle cell crisis in obstetric patients.

Disponível Em: <https://pubmed.ncbi.nlm.nih.gov>