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Continuous papaveretum infusion for the control of pain in painful sickling crisis
P C Sartori1, G J Gordon, P J Darbyshire
1Department of Haematology, Birmingham Children's Hospital.
Insights
Continuous papaveretum infusions effectively managed pain in children with sickling crises. Dosage increased with age, and no respiratory depression occurred, though one case showed cerebral toxicity.
Area of Science:
- Pediatric Hematology
- Pain Management
- Pharmacology
Background:
- Sickle cell disease causes severe pain crises in children.
- Effective pain management in pediatric sickle cell crisis is crucial.
- Opioid analgesics are commonly used but require careful monitoring.
Purpose of the Study:
- To evaluate the efficacy and safety of continuous papaveretum infusions for pain control in pediatric sickle cell crises.
- To assess the relationship between papaveretum dosage and patient age.
- To identify potential adverse events associated with this treatment.
Main Methods:
- Retrospective analysis of 45 occasions of painful sickle cell crises in 24 children (aged 1.7–14.3 years).
- Continuous papaveretum infusions were administered for pain management.
- Infusion duration, total dosage, and adverse events were recorded.
Main Results:
- Continuous papaveretum infusions were used to manage pain in pediatric sickle cell crises.
- Infusion duration ranged from 1 to 9 days (median 3 days).
- Total dosage ranged from 0.3 to 21 mg/kg (median 2.4 mg/kg), with higher doses in older children.
- No respiratory depression was observed.
- One infusion was stopped due to cerebral toxicity.
Conclusions:
- Continuous papaveretum infusions can be an effective option for managing pain in pediatric sickle cell crises.
- Papaveretum dosage appears to correlate with patient age.
- While generally safe, careful monitoring for potential side effects like cerebral toxicity is warranted.
Abstract:
We describe our experience of using continuous papaveretum infusions to control pain in 24 children admitted on 45 occasions with painful sickling crisis. The children were aged from 1.7 to 14.3 years. Infusion duration ranged from one to nine days (median three days), total dose from 0.3 to 21 mg/kg (median 2.4 mg/kg), with a pronounced tendency for dosage to increase with increasing age. No respiratory depression was observed. One infusion was discontinued because of cerebral toxicity.