Pain in children and adolescents with sickle cell anemia: a prospective study utilizing self-reporting.

Purpose: The purpose of this study was to characterize pain reporting among children with sickle cell anemia (SCA) experiencing painful vaso-occlusive crises. These patients were managed according to a protocol based on self-reports of pain.

Patients and methods: Seventeen children (3-18 years) with SCA (Hb SS) who were admitted for painful crisis were asked to report their pain according to a rating scale of 0-5. These pain scores were analyzed according to the Mann-Whitney method to determine differences in pain reporting among young children (3-12 years) and adolescents (13-18 years). The Kruskal-Wallis method was utilized to determine relationships between the number of painful body sites, reported pain scores, and length of hospital stay.

Results: Children (3-12 years) reported significantly less severe pain than adolescents (13-18 years) (p < 0.01). The severity of pain reported was not related to the number of painful sites. However, the length of stay was significantly longer in patients with greater numbers of painful sites (p < 0.05). Patients who reported pain scores of > 2 at 24 h had significantly longer periods of hospitalization.

Conclusion: A protocol based upon self-reports of pain was successfully utilized to provide analgesia during painful crises. There were characteristic differences between young children and adolescents in self-reporting of pain. Pain scores may be helpful in predicting length of hospitalization for painful crises.