Regional anesthesia for sickle cell disease vaso-occlusive crisis: A single-center case series.
Cecile L KarsentyVenée N TubmanChyong-Jy Joyce LiuTitilope FasipeKarla E K WyattPublished in: Pediatric blood & cancer (2022)
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.
Keyphrases
- pain management
- sickle cell disease
- chronic pain
- inflammatory response
- public health
- end stage renal disease
- newly diagnosed
- randomized controlled trial
- chronic kidney disease
- peritoneal dialysis
- prognostic factors
- cardiac surgery
- patients undergoing
- ultrasound guided
- lipopolysaccharide induced
- spinal cord injury
- patient reported outcomes
- bone marrow
- spinal cord
- acute kidney injury
- young adults
- smoking cessation
- cell therapy
- replacement therapy