The Evaluation of Patient-Controlled Analgesia Compared to Standard Opioid Analgesic Therapy in Pain Management Among Patients With Sickle Cell Disease: A Systematic Review and Meta-Analysis Protocol

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL

Health Science Reports Pub Date : 2025-03-18 DOI:10.1002/hsr2.70577

Maria Pramila D'Costa, Melita Sheela Alva, Seyed Aria Nejadghaderi, Salha Humaid Al Bloushi, Wafa Ibrahim Saleh Al Shizawi, Nikhil Muduli, Sana Ahuja, Salma Al-Amri, Alireza Mosavi Jarrahi, Nabeel Al-Yateem, Syed Azizur Rahman, Amina Mohammed Al-Marzouqi

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Abstract

Background and Aims

Sickle cell disease (SCD) is an inherited blood disorder characterized by the production of abnormal hemoglobin S (HbS), leading to the deformation of red blood cells into a sickle shape under low oxygen conditions. These deformed cells impede blood flow, causing vaso-occlusive crises (VOCs), which result in severe pain, multiorgan damage, and increased mortality. Despite advancements in understanding the pathophysiology and management of VOCs, optimal pain management remains a significant challenge. This review aims to evaluate patient-controlled analgesia compared to standard opioid analgesic therapy in pain management among patients with SCD.

Methods

The relevant studies will be searched using a well-formulated search strategy using databases such as PubMed, Embase, Scopus, and Web of Science. It will be screened by two reviewers independently (screening phase), and further, the third reviewer may solve if any discrepancies are noted. The primary outcomes will be pain reduction in intensity and frequency of breakthrough pain reported using a standard pain scale. The secondary outcomes will be adverse reactions, mortality rate, length of hospital stay, and 30-day readmission. Then, the eligible studies are assessed for risk for bias and quality by two review members using the Newcastle–Ottawa Scale for observational studies or Cochrane Risk of Bias assessment tool version 2. Besides, it provides strong evidence in support of patient-controlled analgesia (PCA) as an optimal pain management strategy compared to other pain management strategies. It also explores PCA's safety profiles and common adverse events to provide evidence-based recommendations and establish a standard of care for treating SCD patients.

Results

PRISMA format of reporting systematic review and meta-analysis protocols will be followed while presenting the results of this study.

Conclusion

The findings potentially influence clinical practice, healthcare policy, and future research thereby guiding the development of evidence-based standards for VOC management in SCD patients.