Regional Anesthesia for Sickle Cell Disease Vaso-Occlusive Crisis: A Single-Center Case Series

Authors

Cecile Karsenty
Venée N Tubman
Chyong-Jy Joyce Liu
Titilope Fasipe
Karla E K Wyatt

Publication Date

6-1-2022

Journal

Pediatric Blood & Cancer

DOI

10.1002/pbc.29695

PMID

35373913

PMCID

PMC9172213

PubMedCentral® Posted Date

6-1-2023

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Analgesics, Opioid, Anemia, Sickle Cell, Anesthesia, Conduction, Child, Humans, Pain, sickle cell disease, regional anesthesia, pain management

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.