Regional anesthesia for sickle cell disease vaso-occlusive crisis: A single-center case series.

Regional anesthesia for sickle cell disease vaso-occlusive crisis: A single-center case series.
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DOI:
10.1002/pbc.29695
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发表时间:
2022-06
影响因子:
3.2
通讯作者:
--
中科院分区:
医学3区
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--
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对于出现血管闭塞危象(VOC)的镰状细胞病(SCD)患者来说,疼痛管理是具有挑战性的。阿片类药物治疗非常有效,但不良副作用可能会阻碍其有效性。局部麻醉和神经周围麻醉剂的沉积可提供伤害性阻滞、局部血管扩张和减轻炎症反应。在儿科患者中,持续周围神经阻滞(CPNB)用于围手术期辅助镇痛是安全的。在这里,我们描述了一组患有阿片类药物难治性上肢VOC的儿童SCD患者在放置CPNBs用于止痛后的轨迹;突出了阿片类药物消耗的减少、疼痛评分的改善和住院时间的缩短。
Pain management is challenging for patients with sickle cell disease (SCD) who present in vaso-occlusive crisis (VOC). Opioid therapy is highly effective, nevertheless undesirable side effects can hinder their effectiveness. Regional anesthesia with deposition of perineural anesthetic offers nociceptive blockade, local vasodilatation and reduces the inflammatory response. Among pediatric patients, continuous peripheral nerve block (CPNB) for perioperative adjunctive analgesia is safe. Herein, we describe the trajectory of a cohort of pediatric SCD patients with opioid-refractory upper extremity VOC following placement of CPNBs for analgesia; highlighting reduced opioid consumption, improved pain scores and decreased length of hospitalization.
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