• J. Pediatr. Hematol. Oncol. · Aug 2014

    Case Reports

    Management of refractory pain in hospitalized adolescents with sickle cell disease: changing from intravenous opioids to continuous infusion epidural analgesia.

    • Tamara New, Claudia Venable, Laura Fraser, Erin Rosenberg, Jennifer Schmidt, Anne James-Herry, Ifeyinwa Osunkwo, and Carlton Dampier.
    • *Emory University School of Medicine †Children's Healthcare of Atlanta, Atlanta, GA.
    • J. Pediatr. Hematol. Oncol. 2014 Aug 1; 36 (6): e398-402.

    BackgroundProlonged hospitalizations for sickle cell disease painful episodes are not uncommon, as analgesic options are often suboptimal.ObservationsSeven 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.ConclusionContinuous 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.

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