Patient Evaluation of Patient-Controlled Analgesia for Pain Crises in Sickle Cell Disease.

Abstract

Background: Vaso-occlusive crisis causing severe pain can be seen in patients with sickle cell anemia and potent opioids should be used in this process. Although sickle cell disease (SCD) patients use patient-controlled analgesia (PCA), we encountered no study evaluating this method from the participants' perspective.

Aim: This descriptive study aimed to evaluate the use and effectiveness of PCA administered using the Mersin Algology Protocol (MAP) during painful episodes of SCD based on participants reports.

Methods: After obtaining approval from the local ethics committee, 109 SCD participants using PCA as per the MAP between 2018 and 2020 were recruited for the study. The participants answered a 28-item questionnaire regarding their annual number of pain crises, sites of pain, knowledge about PCA, the number of times they used PCA, and the positive and negative aspects of the PCA method.

Results: The mean age of the participants was 28.80 ± 11.5 years. Ninety-nine (90.8%) of the participants considered PCA superior to other pain management methods they had used previously. The 53 participants (48.6%) who waited for their pain to worsen before administering the demand dose expressed fear of taking high doses of medication. As the number of times a participant used PCA increased, NRS scores for pain at the time of demand dosing decreased from 7-10 to 4-6 (p = .013). Eighty-five (78%) of the participants reported having no problems related to the device or drug while using PCA.

Conclusion: We found that PCA was used more correctly by participants with more experience using the device. Participants who delay demand dosing do so because of anxiety about developing dependence and to avoid high doses.