أزمة الخلايا المنجلية: إدارة الألم الحاد عندما لا يُحقق التسكين الأولي القائم على الأفيونيات السيطرة الكافية

References

DOI: 10.1182/bloodadvances.2020001851

• For adults and children presenting with acute pain related to SCD who are hospitalized, the ASH guideline panel suggests a subanesthetic (analgesic) ketamine infusion as adjunctive treatment of pain that is refractory or not effectively treated with opioids alone (conditional recommendation based on very low certainty in the evidence about effects).
• Recommended dose for subanesthetic (analgesic) infusion for acute exacerbation of SCD pain starts at 0.1 to 0.3 mg/kg per hour with a maximum of 1 mg/kg per hour.
• For adults and children presenting with acute pain related to SCD, the ASH guideline panel suggests regional anesthesia treatment approaches for localized pain that is refractory or not effectively treated with opioids alone (conditional recommendation based on very low certainty in the evidence about effects).
• Regional anesthesia in this context is defined as epidural or peripheral nerve catheter-delivered analgesia for abdominal, hip, or leg pain.