Regional anesthesia for sickle cell disease vaso-occlusive crisis: A single-center case series

Pediatr Blood Cancer. 2022 Jun;69(6):e29695. doi: 10.1002/pbc.29695. Epub 2022 Apr 4.

Abstract

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.

Keywords: pain management; regional anesthesia; sickle cell disease.

MeSH terms

  • Analgesics, Opioid / therapeutic use
  • Anemia, Sickle Cell* / complications
  • Anemia, Sickle Cell* / therapy
  • Anesthesia, Conduction*
  • Child
  • Humans
  • Pain / drug therapy
  • Pain / etiology

Substances

  • Analgesics, Opioid