Arginine in sickle cell vaso-occlusive crisis: A randomised placebo control trial

Abstract

Introduction: Sickle cell disease is one of the most common hemoglobinopathies in India. A vaso-occlusive crisis is one of the most common indications for hospitalization, it accounts for 70% of hospitalization.
Aim & Objective: To compare efficacy of Arginine in vaso-occlusive episode(VOE) management in terms of mean fall in pain score at discharge between intervention (Arginine) & placebo group among sickled children with skeletal vaso-occlusive crisis between 2-14 years of age.
Materials and and Methods: This randomized placebo control study was carried out after getting clearance from the institutional ethical & research committee, from November 2019 to October 2021 in the Indoor of Pediatrics Department, Veer Surendra Sai Institute of Medical Science (VIMSAR), Burla, Sambalpur.
Observation: There is significant fall in pain score in case group as compared with control group as evidenced by p value being less than 0.001, indicating that l-arginine has significant role in reducing sickle cell vaso-occlusive episode. Mean Length of stay (LOS) in hospital in case group was 2.16, while in control group was 2.69. p value being calculated showed the value to be less than 0.001, which shows importance of l-arginine in reducing in mean length of stay in hospitalization.
Conclusion: L-arginine plays a vital role in treating vaso-occlusive episodes. It helps to reduce the pain gradually as evidenced by noting down pain score at the time of admission & every 24 hours of therapy till discharge. It also helps to reduce the mean duration of hospitalization in vaso-occlusive episode.