Patient Controlled Analgesia for Vaso-Occlusive Episodes in Children: A Retrospective Study

Donado, Carolina; Harris, Emily M.; Heeney, Matthew M.; Solodiuk, Jean C.; Greco, Christine; Archer, Natasha M.

doi:10.1016/j.jpainsymman.2022.12.147

Cited by 1 publication

(2 citation statements)

References 16 publications

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“…The mainstay for management of VOC remains opioids. [10][11][12][13][14] Nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen are added as adjunctive therapies with opioids. Both acetaminophen and NSAIDs can be used to decrease opioid requirements as well as opioid-related adverse effects including constipation, hypoventilation, pruritus, ileus, nausea/vomiting, and opioid tolerance.…”

Section: Pain Manag Ement In Vo Cmentioning

confidence: 99%

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Regional anesthesia and sickle cell crisis in pediatric patients: An educational‐focused review

Elhamrawy,

Veneziano,

Tobias

2023

Pediatric Anesthesia

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IntroductionSickle cell disease (SCD) is the most common inherited hemoglobinopathy, affecting approximately 100 000 patients in United States and millions worldwide. Although the mainstay of pain management for VOC remains systemic opioids, given the potential for adverse effects including respiratory depression and hypoxemia, there remains interest in the use of regional anesthetic techniques (neuraxial or peripheral nerve blockade).MethodsA systematic search of pubMed, Scopus, and Google Scholar was conducted using the terms sickle cell disease, sickle cell crisis, pain crisis, vaso‐occlusive crisis, regional anesthesia, peripheral nerve blockade, and neuraxial anesthesia.ResultsWe identified 7 publications, all of which were retrospective case series or single case reports, outlining the use of neuraxial anesthesia in a total of 26 patients with SCD. Additionally, we identified 4 publications, including one retrospective case series and 3 single case reports, entailing the use of peripheral blockade in patients with VOC and SCD.DiscussionThe available literature, albeit all retrospective or anecdotal, suggests the potential utility of regional anesthesia to treat pain in patients with SCD. Additional benefits have included avoidance of the potential deleterious physiologic effects of systemic opioids and in one case series, an improvement in respiratory function as judged by pulse oximetry. The anecdotal and retrospective nature of the available reports with an absence of prospective trials limits the evidence based medicine available from which to develop to guidlines for the optimal local anesthetic agent to use, its concentration, the rate of infusion, and the choice of adjunctive agents.

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Section: Pain Manag Ement In Vo Cmentioning

confidence: 99%

“…The majority of hospitalizations related to SCD relate to the need for acute pain management of VOC. The mainstay for management of VOC remains opioids 10–14 . Nonsteroidal anti‐inflammatory drugs (NSAIDs) and acetaminophen are added as adjunctive therapies with opioids.…”

Section: Pain Management In Vocmentioning

confidence: 99%