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区域性麻醉治疗镰状细胞病血管阻塞性危象:单中心病例系列。

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

机构信息

Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Houston, Texas, USA.

Department of Pediatrics, Baylor College of Medicine, Houston, Houston, Texas, USA.

出版信息

Pediatr Blood Cancer. 2022 Jun;69(6):e29695. doi: 10.1002/pbc.29695. Epub 2022 Apr 4.

Abstract

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.

摘要

疼痛管理对于患有镰状细胞病 (SCD) 并出现血管阻塞性危象 (VOC) 的患者来说具有挑战性。阿片类药物治疗非常有效,但不良反应可能会影响其疗效。外周神经阻滞联合局部浸润麻醉可提供镇痛、局部血管扩张,并减轻炎症反应。在儿科患者中,连续外周神经阻滞 (CPNB) 用于围手术期辅助镇痛是安全的。在此,我们描述了一组接受 CPNB 镇痛的阿片类药物难治性上肢 VOC 儿科 SCD 患者的轨迹;结果表明,阿片类药物的消耗减少,疼痛评分改善,住院时间缩短。

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