Successful epidural analgesia for a vaso-occlusive crisis of sickle cell disease during pregnancy: a case report

We describe a 19-year-old Cameroonian primigravid young woman with sickle cell disease who was admitted to a local hospital in Cameroon where the first author performed his internship gynecology and obstetrics. She presented at 28 weeks of gestation with severe pain in her left leg caused by a vaso-occlusive crisis. As recommended, high doses of intravenous morphine were administered, but without significant pain relief. She received a single bolus injection of 5 mg morphine, followed by a continuous infusion of 0.05 mg/kg/h during 48 h. Lumbar epidural blockade with bupivacaine combined with sufentanil successfully alleviated her severe peripheral ischemic pain induced by a vaso-occlusive crisis caused by sickle cell disease. Until now, only one case report and no clinical trials have been published concerning the use of epidural analgesia for treatment of a vaso-occlusive crisis of sickle cell anemia in a pregnant woman who is not in labor.