Intravenous narcotic therapy for children with severe sickle cell pain crisis

T. B. Cole, R. H. Sprinkle, S. J. Smith, G. R. Buchanan

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Few studies have been published about analgesic management practices during sickle cell pain crisis. Therefore, we reviewed the records of all hospitalized children with this complication during a recent five-year period. The 38 patients (98 painful episodes) who received intravenous narcotic therapy were the subjects of this review. In 76 patients, an initial intravenous bolus injection of morphine sulfate or meperidine hydrochloride was followed by a continuous intravenous infusion of one of these two drugs. To achieve adequate pain control, adjustments in infusion rates were made according to a written protocol. In 22 other patients, subsequent narcotic treatment consisted only of intermittent intravenous bolus injections of meperidine. Satisfactory pain relief was achieved in all 98 episodes. Patients given continuous infusions required more narcotic to control their pain and had more side effects than those treated with bolus injections alone, suggesting a dose-response relationship between narcotic dose and several known side effects. Common side effects included nausea and vomiting, lethargy, and abdominal distention. Although clinically evident respiratory depression was quite uncommon, chest syndrome was a frequent complication, and severe respiratory distress occurred in three patients. Narcotic withdrawal or addiction was not observed. With careful monitoring (including special attention directed to avoiding dosing error), continuous intravenous narcotic infusions are safe and provide effective pain relief for severe sickle cell pain crisis.

Original languageEnglish (US)
Pages (from-to)1255-1259
Number of pages5
JournalAmerican Journal of Diseases of Children
Volume140
Issue number12
StatePublished - 1986

Fingerprint

Narcotics
Pain
Meperidine
Intravenous Infusions
Intravenous Injections
Therapeutics
Social Adjustment
Lethargy
Hospitalized Child
Drug and Narcotic Control
Practice Management
Respiratory Insufficiency
Morphine
Nausea
Vomiting
Analgesics
Thorax
Injections
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Intravenous narcotic therapy for children with severe sickle cell pain crisis. / Cole, T. B.; Sprinkle, R. H.; Smith, S. J.; Buchanan, G. R.

In: American Journal of Diseases of Children, Vol. 140, No. 12, 1986, p. 1255-1259.

Research output: Contribution to journalArticle

Cole, T. B. ; Sprinkle, R. H. ; Smith, S. J. ; Buchanan, G. R. / Intravenous narcotic therapy for children with severe sickle cell pain crisis. In: American Journal of Diseases of Children. 1986 ; Vol. 140, No. 12. pp. 1255-1259.
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