Sodium Citrate Orally for Painful Sickle Cell Crises

Abstract

Nine patients with sickle cell anemia and one with hemoglobin S-C disease in severe painful crises of less than 15 hours' duration were treated with codeine and with orally administered doses of 60 ml of 10% sodium citrate mixed with water to a final volume of 400 ml every 2 hours for 24 hours with tapering doses thereafter. The duration of pain in patients receiving citrate orally plus codeine was comparable to that observed in eight patients receiving 2,000 ml of M/6 sodium lactate intravenously. The duration was significantly less in both series treated with alkali than in eight patients receiving codeine without alkali. Administration of 400 ml of water every two hours without alkali was ineffective in two patients and death occurred in one patient so treated.