New Tamara, Venable Claudia, Fraser Laura, Rosenberg Erin, Schmidt Jennifer, James-Herry Anne, Osunkwo Ifeyinwa, Dampier Carlton
*Emory University School of Medicine †Children's Healthcare of Atlanta, Atlanta, GA.
J Pediatr Hematol Oncol. 2014 Aug;36(6):e398-402. doi: 10.1097/MPH.0000000000000026.
Prolonged hospitalizations for sickle cell disease painful episodes are not uncommon, as analgesic options are often suboptimal.
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.
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.
镰状细胞病疼痛发作导致的长期住院并不罕见，因为镇痛选择往往不尽人意。
7例患者（年龄15.4±3.7岁，6名女性）接受硬膜外镇痛以治疗顽固性疼痛。硬膜外导管置入的中位持续时间为4天（四分位间距为3至6天）。平均疼痛评分从6.8±2.7降至4.8±2.2，而每日胃肠外阿片类药物平均需求量从79.7±100.4毫克吗啡当量降至13.0±13.1毫克。
对于患有顽固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一种替代方法，并且可能减少阿片类药物相关副作用并有助于向口服镇痛药过渡。
