Sousa Bárbara, Nunes Joana, Ribeiro Andreia Fiúza
Department of Anesthesiology, Hospital Professor Dr. Fernando Fonseca, Portugal.
Pediatric Special Intensive Care Unit, Hospital Professor Dr. Fernando Fonseca, Portugal.
Indian J Anaesth. 2024 Apr;68(4):394-396. doi: 10.4103/ija.ija_768_23. Epub 2024 Mar 13.
Sickle cell disease is characterised by episodes of vaso-occlusive crisis, a painful complication. Regional anaesthesia has shown promising results in reducing opioid consumption and pain scores. Patients with vaso-occlusive crises who underwent regional anaesthesia in the paediatric intensive care unit were studied. Data regarding pain location, regional analgesia technique, the local anaesthetic used and dose, daily opioid consumption, daily pain scores, use of adjuvants and complications were recorded. The primary outcome was to evaluate the effect of regional anaesthesia on opioid consumption. In this study, we describe 10 cases, referring to six paediatric patients with the vaso-occlusive crisis who underwent regional anaesthesia for severe pain and were unresponsive to increasing doses of opioids. Six cases received epidural analgesia, three continuous peripheral nerve blocks and one received both techniques. Opioid consumption was reduced (58%), and pain scores decreased (72%), both statistically significant reductions.
镰状细胞病的特征是血管闭塞性危机发作，这是一种疼痛性并发症。区域麻醉在减少阿片类药物用量和疼痛评分方面已显示出有前景的结果。对在儿科重症监护病房接受区域麻醉的血管闭塞性危机患者进行了研究。记录了有关疼痛部位、区域镇痛技术、所用局部麻醉药及其剂量、每日阿片类药物用量、每日疼痛评分、辅助药物的使用及并发症的数据。主要结局是评估区域麻醉对阿片类药物用量的影响。在本研究中，我们描述了10例病例，涉及6例患有血管闭塞性危机的儿科患者，他们因剧痛接受了区域麻醉，且对不断增加剂量的阿片类药物无反应。6例接受了硬膜外镇痛，3例接受了连续外周神经阻滞，1例同时接受了这两种技术。阿片类药物用量减少了（58%），疼痛评分下降了（72%），两者均有统计学意义的降低。
