Management of Refractory Pain in Hospitalized Adolescents With Sickle Cell Disease: Changing From Intravenous Opioids to Continuous Infusion Epidural Analgesia
Management of Refractory Pain in Hospitalized Adolescents With Sickle Cell Disease: Changing From Intravenous Opioids to Continuous Infusion Epidural Analgesia
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DOI：
10.1097/mph.0000000000000026
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发表时间：
2014-08-01
影响因子：
1.2
通讯作者：
Dampier, Carlton
中科院分区：
文献类型：
--
作者：
New, Tamara;Venable, Claudia;Dampier, Carlton
背景：因镰状细胞病疼痛发作而长期住院的情况并不少见，因为镇痛选择往往不是最理想的。观察结果：7 名患者（15.4 +/- 3.7 岁，6 名女性）因顽固性疼痛而接受硬膜外镇痛治疗。硬膜外导管置入的中位持续时间为 4 天（四分位数范围，3 至 6 天）。平均疼痛评分从 6.8 +/- 2.7 变为 4.8 +/- 2.2，而平均每日肠外阿片类药物需求量从 79.7 +/- 100.4 变为 13.0 +/- 13.1 毫克吗啡当量。结论：对于患有难治性疼痛的镰状细胞病患者，持续硬膜外镇痛是持续静脉注射阿片类药物的替代方案，并且可以减少阿片类药物相关的副作用和副作用。促进向口服镇痛药的过渡。
Background: Prolonged hospitalizations for sickle cell disease painful episodes are not uncommon, as analgesic options are often suboptimal.Observations: Seven patients (15.4 +/- 3.7 y, 6 females) were treated with epidural analgesia for refractory pain. The median duration of epidural catheter placement was 4 days (interquartile range, 3 to 6 d). Mean pain scores changed from 6.8 +/- 2.7 to 4.8 +/- 2.2, whereas mean daily parenteral opioid requirements changed from 79.7 +/- 100.4 to 13.0 +/- 13.1 mg of morphine equivalents.Conclusion: Continuous epidural analgesia is an alternative to continuing intravenous opioids in sickle cell disease patients with refractory pain, and may reduce opioid-related side effects and facilitate transition to oral analgesics.