Vaso-occlusive crisis

Vaso-occlusive crisis- Pain

The most common complication in SCD is a vaso-occlusive crisis (VOC). These episodes usually present with sudden onset of severe pain, often localized to the extremities, chest, or back, but with few objective findings. Nearly all persons with SCD will have a VOC during their lifetime sometimes as early as six months of age, when it presents as dactylitis. Recurrences have variable presentations and frequency. VOC is a clinical diagnosis with no objective diagnostic tests. Other potential causes for the acute pain should be excluded while providing required analgesia. Primary management of VOC includes rapid triage, assessment, and administration of appropriate analgesics. Pain management should be based on patient-reported pain severity. For mild or moderate pain, treatment may begin with nonsteroidal anti-inflammatory drugs, if they are not contraindicated. For more severe pain, opioids are the first-line therapy; they should be provided immediately and therapy should be guided by the patient's history of previous successful regimens. Meperidine (Demerol) should not be used unless it is the only effective alternative available. Hydration and other nonpharmacologic therapies (e.g. maintaining body temperature) may also be useful.


From : Management of Sickle Cell Disease: Recommendations from the 2014 Expert Panel Report

Last modified
31 March 2021

N02BE01 Paracetamol

N02AA01 Morfine


D57.00 Hb-SS disease with crisis, unspecified

Rare Condition

Sickle Cell Disease

Sickle cell disease (SCD) is a red blood cell disease, a complex inherited disorder with multisystem manifestations that requires specialized comprehensive care to achieve an optimal...


Recurrent bone pain in a child may indicate for example:

General Medical Guideline
Specific Medical Guideline
Score Predicting Acute Chest Syndrome During Vaso-occlusive Crises in Adult Sickle-cell Disease Patients