Approaching Complex Pain in a Child with a Vaso-Occlusive Crisis: A Clinical Case

Authors

  • Larissa Morais Interna de Formação Específica de Anestesiologia, Hospital Espírito Santo de Évora https://orcid.org/0000-0001-7906-8240
  • Inês Portela Interna de Formação Específica de Anestesiologia, Centro Hospitalar Universitário do Algarve, Faro, Portugal https://orcid.org/0000-0001-5284-457X
  • Ana Paulino Assistente Hospitalar de Anestesiologia, Serviço de Anestesiologia, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal https://orcid.org/0000-0003-2340-9485
  • Célia Xavier Assistente Hospitalar Graduada de Anestesiologia Serviço de Anestesiologia, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal https://orcid.org/0000-0001-5024-8598

DOI:

https://doi.org/10.25751/rspa.25723

Keywords:

Neuropatic Pain, Drepanocytosis, Pediatric, Gabapentin

Abstract

Pain from the vaso-occlusive crisis of sickle cell disease is a frequent and debilitating manifestation. While the nociceptive component is easily recognized and potentially controlled with conventional therapy, the neuropathic component is underdiagnosed and undertreated. There is little evidence for the use of membrane stabilizers, indicated in neuropathic pain (NP), in sickle cell disease. We present the case of a 7-year-old child with multiple hospitalizations and uncontrolled pain under conventional therapy and opioids. Gabapentin was shown to be effective in pain control and the present work contributes to the evidence that NP is a reality in these patients.

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References

Sharma, D. & Brandow, A. M. Neuropathic pain in individuals with sickle cell disease. Neu-rosci. Lett. 714, 134445 (2019).

Toste, S., Palhau, I. L. & Amorim, I. R. Dor Neuropática em Idade Pediátrica Neuropathic. Rev. da Soc. Port. Med. Física e Reabil. 27, 22–29 (2015).

Brandow, A. M., Farley, R. A., Desgupta, M., Hoffmann, R. G. & Panepinto, J. A. The Use of Neuropathic Pain Drugs in Children with Sickle Cell Disease is Associated with Older Age, Female Gender and Longer Length of Hospital stay. J Pediatr Hematol Oncol 37, 10–15 (2015).

Nottage, K. A. et al. Addressing challenges of clinical trials in acute pain: The Pain Manage-ment of Vaso-occlusive Crisis in Children and Young Adults with Sickle Cell Disease Study. Clin. Trials 13, 409–416 (2016).

Ballas SK, Darbari DS. Neuropathy, neuropathic pain, and sickle cell disease. Am J Hematol 88(11), 927‐9 (2013).

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Published

2022-04-22

How to Cite

Morais, L., Portela, I., Paulino, A. ., & Xavier , C. . (2022). Approaching Complex Pain in a Child with a Vaso-Occlusive Crisis: A Clinical Case. Journal of the Portuguese Society of Anesthesiology, 31(1). https://doi.org/10.25751/rspa.25723

Issue

Vol. 31 No. 1 (2022): Revista da Sociedade Portuguesa de Anestesiologia

Section

Case Report

License

Copyright (c) 2022 Larissa Morais, Inês Portela, Ana Paulino, Célia Xavier

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