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Epidural Analgesia for Treatment of a Sickle Cell Crisis During Pregnancy

Winder, Abigail D. MD; Johnson, Stacie MD; Murphy, Jamie MD; Ehsanipoor, Robert M. MD

doi: 10.1097/AOG.0b013e3182267e58
Case Reports
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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.

Epidural analgesia can provide effective pain control for obstetric patients with severe pain due to a sickle cell crisis.

From the Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD; Department of Anesthesiology, Johns Hopkins University, Baltimore, MD.

Corresponding Author: Abigail D. Winder, MD, Johns Hopkins University, Department of Gynecology and Obstetrics, 600 North Wolfe Street, Phipps 279, Baltimore, MD 21287; e-mail: abigailwinder@gmail.com.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2011 The American College of Obstetricians and Gynecologists