PR Parida, B Pradhan, BK Barik, PK Padhi, SR Pattnaik, MK Sahu, BK Kullu
Objective
of the
Study :
To study
the
effect
of L-Arginine
in
sickle
cell
pain
crises.
Methodology:
Sixty
consecutive
known
patients
of
sickle
cell
disease
(ss)
with
vasoocclusive
pain
crisis
admitted
to
general
medical
ward
were
taken
into
study.
Routine
relevant
haematological
and
other
study
were
done for
every
patients.
L-Arginine
8 gm/day
in
divided
doses 8
hourly
was
given
orally
to 30
patients
of trial
group
with
consent
of
patients
or their
relatives
along
with
current
therapy
of
controlled
gentle
hydration.
Oxygen
and
analgesic.
Control
group
patients
were
managed
with
same
current
conservative
therapy
but
without
L-Arginine
. Rating
of pain
scale
was done
daily 8
hourly.
Observation:
There
were 22
male and
8
females
on trial
group
and 24
male and
6 female
in
control
group.
Age
range
was
between
15-35
years.
17 cases
(56.7%)
were age
range
between
15-20
years in
trial
group
and 18
cases
(60%) in
control
group.
At
presentation
patients
were
classified
in 3
group
according
to pain
scale
(0-10)
into
mild,
moderate
and
severe
pain .
Trial
group
has mild
pain in
2 cases
(6.6%),
moderate
pain in
14 cases
(46.7%),
severe
pain in
14 Cases
(46.7%)
and in
control
group
mild
pain in
2 cases
(6.6%),
moderate
pain in
15 (50%)
and
severe
pain in
13 cases
(43.4%).
There
was no
adverse
effects
due to
L-arginine
in this
study in
short
term.
Resolution
of pain
after
giving
L-arginine
in trial
group
with
mild ,
moderate
and
severe
pain was
48 hours
, 60
hours
and 88
hours
respectively
in
comparison
to
control
group
with
mild
moderate
and
severe
pain,
which
was 72,
96 and
128
hours
respectively.
There
was a
difference
of
decreased
pain
duration
in trial
group by
24 hour
, 36
hours
and 40
hours
respectively.
Conclusion:
From
this
study it
is
concluded
that
administration
of L-arginine
in
sickle
cell
pain
crisis
along
with
conventional
conservative
therapy
can
lessen
the
duration
of pain
crisis
in
comparison
to
conservative
therapy
alone.
Patients
having
severe
pain at
the time
of
admission
took
longer
time to
pain
resolution
in both
groups.
However
randomized
double
blind
placebo
controlled
intention
to treat
trial
should
be done
in large
number
of
patients
in
multicentre
to
conclude
its
effectiveness.
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