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. 2017 Oct-Dec;11(4):437-441.
doi: 10.4103/sja.SJA_228_17.

Assessment of patient-controlled analgesia versus intermittent opioid therapy to manage sickle-cell disease vaso-occlusive crisis in adult patients

Alaa Al-Anazi  1 , Lowloa Al-Swaidan  1   2 , Maha Al-Ammari  1   2 , Tariq Al-Debasi  3 , Abdulmalik M Alkatheri  1   2 , Shmeylan Al-Harbi  1   2 , Aiman A Obaidat  2 , Abdulkareem M Al-Bekairy  1   2
Affiliations

Assessment of patient-controlled analgesia versus intermittent opioid therapy to manage sickle-cell disease vaso-occlusive crisis in adult patients

Alaa Al-Anazi et al. Saudi J Anaesth. 2017 Oct-Dec.

Abstract

Background: Vaso-occlusive crisis (VOC) is one of the acute complications of sickle-cell disease (SCD). Treatment mainly relies on hydration and pain control by analgesics. The specific aim of this study was to assess potential health outcomes within the first 72 h of admission between intermittent and patient-controlled analgesia (PCA) by opioids among VOC patients.

Methods: A retrospective chart review study was conducted to determine SCD patients with VOC. Using the hospital electronic system, the following data were collected: patient's age, gender, blood pressure, heart rate, respiratory rate, oxygen saturation, and pain score on admission and daily for 3 days as well as the cumulative opioid analgesic dose for 72 h which is reported as morphine equivalent.

Results: One hundred and seventeen patients were screened over a period of 5 years. Of those, 99 (84.6%) met the study inclusion criteria, and 18 patients (15.4%) were excluded from the study. During the first 72 h of admission, a significant reduction in pain score was observed in patients on intermittent intravenous (IV) administration compared to those in the PCA group (P < 0.0004) where the mean pain scores were 3 and 5, respectively. The total amount of morphine administered over 72 h of admission was significantly higher in PCA group (777 ± 175 mg) as compared to the intermittent IV administration group (149 ± 74 mg) (P < 0.000003). Clinically significant hypotension or respiratory depression was not observed in both groups over the 72 h of admission.

Conclusion: During the first 72 h of admission, intermittent IV administration of morphine was more effective than PCA infusion in pain control.

Keywords: Anesthesia; morphine; opioids; sickle-cell disease.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Patients' enrollment in the study
See this image and copyright information in PMC

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