Document Type : Research articles
Authors
- Morteza Talebi Doluee
- Behrang Rezvani Kakhki
- Hamid Heidarian Mir
- Mahsa Fateminayyeri
- Farideh Madanitorbati
- Somayyehalsadat Hosseini
Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract
Background: Sickle cell disease (SCD) is a congenital hemoglobinopathy. A low Hb level and high hemoglobin-to-hematocrit ratio may lead to the vaso-occlusive crisis in patients, for the management of which hyperbaric oxygen, hydration, and pain relief therapy are proposed.
Objectives: In this study, we sought to compare the effects of morphine and ketorolac on relieving painful sickle cell crisis.
Methods: In this double-blind, randomized clinical trial, we recruited 92 SCD patients who referred to the Emergency Department of a university-affiliated hospital, in Mashhad, Iran, from December 2016 to May 2017. The patients were randomly assigned to two groups of ketorolac and morphine injections for relieving pain crisis according to the clinical conditions of the patients. Pain sever- ity was measured by the visual analogue scale before and after the intervention. Data were analyzed using SPSS software.
Results: A total of 92 SCD patients were evaluated, while, 19 (21%) were female and 73 (79%) were male, with the mean age of 20.77 ± 8.6 years. At the pre-injection phase, the mean pain scores were 9.1 ± 0.4 and 9.1 ± 0.7 in the ketorolac and morphine groups, respec- tively. After the intervention, the mean pain scores were 3.7 ± 1.2 and 4.9 ± 2.1 in the ketorolac and morphine groups, respectively. A significant association was found between the pain score after drug injection and the administered drug (P = 0.006).
Conclusions: The management of pain crisis with ketorolac injection yielded the same results as the morphine injection in SCD pa- tients. However, ketorolac was found to be associated with fewer side effects than morphine; thus, it can be beneficial for managing SCD patients suffering pain crisis.
Keywords
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