Patient-controlled analgesia pain management for children with sickle cell disease.
Painful episodes account for approximately 60% of all hospitalizations of children and adults with sickle cell disease. Limited information is available on managing pain in these individuals. Increasing attention is being focused on new ways to promote pain control. A new, safe, and effective way to achieve pain relief and control is through patient-controlled analgesia (PCA). This report describes our experiences using PCA in children with sickle cell disease. Over an 18-month period, 61 children considered to have severe or intolerable pain (unassociated with infection or organ-related disease) were treated with PCA. The records of 10 children selected randomly from the 61 were examined and compared with those of 10 children also randomly selected who had been treated using a conventional, fixed-schedule approach. Time in the hospital, time until tapering of narcotic, time until pain relief, and duration of parenteral narcotic therapy were similar between the two groups. Total dose of intravenous narcotic therapy (meperidine equivalent in mg/kg) was greater in the PCA group. Five of 10 children using PCA, however, experienced relief within 6 hours compared with 1 of 10 children in the non-PCA group (P = .052). Patients, families, and hospital staff expressed satisfaction and preferred PCA to conventional management when offered a choice.
Holbrook
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East Carolina University School of Medicine, Children's Hospital of Eastern North Carolina, Greenville 27858-4354.
D000293:Adolescent; D000328:Adult; D016058:Analgesia, Patient-Controlled; D000755:Anemia, Sickle Cell / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D010146:Pain / Q000188:drug therapy*