Can Sickle Cell Pain Be Treated by Nitric Oxide Inhalation?

The prevalence of sickle-cell disease in the United States is nearly 1 in 5,000 people. According to the National Health Institutes, 1 in 500 black births have this condition with Sub-Saharan African descent.

The major reason for the hospitalization of these patients is owing to a condition known as Sickle cell pain. The aching experienced is part of the various acute and chronic complications, technically known as sickle cell crisis and lasting for five to seven days.

The researchers at the Department of Anesthesiology at the Medical College of Georgia School of Medicine have found that inhaling nitric oxide gas can treat this pain. The results of their findings were published in the October 2010 issue of the journal American Journal of Hematology.

What is Sickle Cell Pain?
The red blood cells are type of blood cells which provide oxygen to every functional cell in the body. They have round structure which helps them to travel along the blood smoothly. But in patients suffering from sickle cell anemia, the shape of these cells is distorted and they become sticky.

This development causes blockage of the cells in the blood vessels through which they travel. Such a blockage leads to very intense painful phases called vaso-occlusive crises.

Unfortunately different people experience the pain differently as par its duration, frequency and severity. Analgesics are the prescribed drugs to deal with this aching. Opioid administration at regular intervals is part of the pain management technique. NSAIDs like diclofenac or naproxen can treat mild form of this pain.

Patient-controlled analgesia (PCA) devices are required to inject intravenous opioids in hospitalized patients for managing severe form of this pain. Use of the opioids can cause itching in the patients for which a drug Diphenhydramine is prescribed the doctors mostly.

How Nitric Oxide Inhalation Can Reduce Sickle Cell Pain?

  • In small study with 18 patients in Atlanta, Chicago and Detroit, nine of the participants were made to inhale nitric oxide for four hours.
  • They reported feeling better when compared to the patients who experienced relief provided by the standard self-administered morphine.
  • The exact mechanism of how this gas treats this pain is not understood yet.

The researchers have certain evidences which suggest that nitric oxide might get attached to hemoglobin protein. As a result the natural shape of the red blood cells might get restored back.

The stickiness which is primarily responsible for this crisis is also suspected to get reduced by the gas inhalation along with the inhibition of new formation of such blockages.

  • The researchers are further claiming that one of the functions of this gas in the body may be prevention of blood clot.
  • The dose of the gas required to experience this relief was less than the dose of morphine and no toxicity was observed by its inhalation.
  • Further research is focused on replacing morphine with nitric oxide gas in the near future to treat sickle-cell disease pain.

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