Save
RAPID ONSET OPIOIDS FOR TREATMENT OF ACUTE ISCHEMIC-HEMOLYTIC PAINFUL CRISIS IN DREPANOCYTOSIS
ESRA Academy. SCIMIA P. Sep 8, 2016; 138301; 0128 Topic: MISCELLANEOUS
PAOLO SCIMIA
PAOLO SCIMIA

Access to Premium content is currently a membership benefit.


Click here to join ESRA or renew your membership.

Abstract
Discussion Forum (0)
Rate & Comment (0)
Background and Aims:

Sickle Cell Anemia (SCA) or drepanocytsis is an hereditary blood disease, characterized by alteration of hemoglobin,  abnormal sickle shape and  rigid red blood cells that are more fragile and they will break more easily than normal ones: this explaining both the type of anemia (hemolytic) and  the predisposition to clog capillaries, with severe painful ischemia in the tissues at different  territories.

Methods:

Author retrospectively reports the management of acute, generalized, intractable pain occurred  during SC hemolysis in 18 adult outpatients. Of all patients (10 female and 8 male, mean age 37±4.5 years) demographic, clinical and pharmacological data were recorded, to determine the time, the character, intensity and duration of pain in during of hemolytic crisis, the efficacy and safety of oral or nasal trans mucosal administration of rapid onset fentanyl (ROOf).

Results:

In all patients, pain had a gradual onset, presenting (in 11 of 18 subjects) as a pain in the right upper quadrant and mesogastrium. Pain, severe (NRS 95±40) was constricting, migrant to the lumbar region. Later, it became generalized, less intense (NRS 70-80), but exhausting and burning, worsened with the finger pressure of the abdominal wall muscles. 5 patients were treated as opioid naïve, 13 patients received a total amount of subcutaneous and oral opioids equal to 60±25 mg of morphine without benefit. The early administration of ROOf generated a good and stable analgesia. No adverse events were recorded in all patients.
                                    
     

Conclusions:

Severe pain after SC hemolisis and vasoocclusive reaction could be successfully manage with sudden of ROO fentanyl.

Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.



Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.


Save Settings