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首页> 外文期刊>American Journal of Hematology >Pain management in children and adolescents with sickle cell disease.
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Pain management in children and adolescents with sickle cell disease.

机译：镰状细胞病儿童和青少年的疼痛处理。

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摘要

In a cohort of 2,194 children with sickle cell disease (SCD) treated in community-based services, we explored the types of medications used to treat vaso-occlusive (VOC) pain episodes, and the relative effectiveness of nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and adjunctive antidepressants or anticonvulsant medications on reducing acute VOC pain visits over time. Pharmacologic treatments for VOC pain consisted mainly of NSAIDs and weak opioids. Significantly more patients with more than 3 inpatient or ER VOC pain visits during their first year of SCD treatment were prescribed stronger opioids, SSRIs, SNRI/heterocyclics, and anticonvulsants. Prescription of both stronger opioids and SSRI antidepressants or anticonvulsants was significantly associated with lower cumulative rates of acute VOC pain visits over time. Using an observational study design and existing clinical data, these findings are intended to illustrate the potential clinical advantages of combining adjunctive antidepressants or anticonvulsants with primary pain medications for relief of acute VOC pain over time.
机译：在以社区为基础的治疗中的2194名镰状细胞病（SCD）儿童队列中，我们探讨了用于治疗血管闭塞（VOC）疼痛发作的药物类型以及非甾体类抗炎药（NSAIDs）的相对有效性），阿片类药物和辅助抗抑郁药或抗惊厥药，可随着时间的流逝减少急性VOC疼痛的发作。 VOC疼痛的药物治疗主要包括NSAID和弱阿片类药物。在接受SCD治疗的第一年中，有3例住院或ER VOC疼痛就诊次数超过3次的患者中，使用了更强的阿片类药物，SSRI，SNRI /杂环类药物和抗惊厥药。随着时间的推移，更强的阿片类药物和SSRI抗抑郁药或抗惊厥药的处方与急性VOC疼痛就诊的累积累积率降低显着相关。使用观察性研究设计和现有临床数据，这些发现旨在说明将辅助抗抑郁药或抗惊厥药与主要止痛药合用以缓解急性VOC疼痛的潜在临床优势。

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