Efficacy of tenoxicam (tenoksan) vis a vis diclofenac k~+ in achieving effective pain control in sickle cell painful crises

摘要

In the past, various treatment modalities were applied to achieve pain control in sickle cell disease. However, the outcome has been frustrating both in terms of efficacy, side effects and cost implications. This causes the high morbidity and early mortality attributable to the complication of the disease. The essence of this work is to improve on this care in terms of efficient control of pains and to evaluate the tolerability and effectiveness of Tenoxicam vis a vis diclofenac k~+ in achieving pain control in painful sickling crises. A total of 300 sickle cell disease patients with painful crises over 1 year period were recruited and grouped into those on Tenoxicam and those on diclofenac k+. Patient biodata and history of the clinical condition, samples for FBC pre-therapy and post therapy were taken and results of our findings analysed using SPSS version 11, 2002 package. 150 patients with sickle cell disease painful crises in each group were recruited into the study aged between 15-49 years. All the adult patients presented with mild to severe pains which were in form of vaso-occlusive crisis, Avascular Necrosis (AVN), Acute Chest Syndrome (ACS), Gastro-intestinal (GIT) infarctive crises, acute osteomyelitis, cephal haematoma and infections. Infection (plasmodium falciparum and sepsis) were the commonest precipitating factors for sickling crises in our patients. There is an inverse correlation between the stratified clinical pain expression with the duration of Tenoksan usage. Fifteen (15) of the tenoxicam group experienced some unwanted side effects in form of GIT bleeding, abdominal cramps, Skin rashes (Lyell's syndrome) and headache. There is statistically significant difference between the mean PCV, WBC count in pre-therapy and post therapy values while as there was no significant difference in the mean platelet counts. Tenoxicam (Tenoksan) has been judged to be tolerant, efficient in achieving pain control in both acute and chronic pain syndromes, such as AVN, frequent acute painful crises in patient with sickle cell disease.