Selma ÜNAL, Mesut BAKIR, Şebnem Rumeli ATICI, Hüseyin Utku YILDIRIM, Eyüp Naci TİFTİK

Orak hücre anemisi ağrılı krizlerinde hasta kontrollü analjezi ile morfin tüketimi: Yeni bir protokol

Amaç: Orak hücreli aneminin ağrılı krizlerinde ağrının ani gelişen ve hızla yükselen şiddeti, sıklıkla güçlü opioid kullanımı gerektirmektedir. Bununla birlikte hastalar saatler içerisinde sürekli farklı doz (arttırma/azaltma) uygulamalarına ihtiyaç duymaktadırlar. Bu çalışma ile retrospektif olarak, ağrılı krizlerde, standardizasyonu görsel ağrı skalası (VAS) ve hasta kontrollü analjezi yöntemindeki (HKA) hasta istek sayısına göre yapılandırılmış bir protokolün, morfin tüketimi üzerine etkisinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: 2004–2018 yılları arasında, analjezisi için protokole uygun olarak, HKA yöntemi ile morfin uygulanan, 93 hastanın 177 ağrılı krizi incelendi. Hastaların demografik verileri, hemoglobin kromotografileri ve genotipleri, ağrılı dönem takip süresi, tedavi öncesi ve sonrası VAS değerleri, günlük morfin tüketimleri kaydedildi. Yaş grupları ve cinslere göre ağrılı kriz dönemi morfin tüketimleri karşılaştırıldı. Bulgular: Hastaların %57’sinin homozigot tip olan Hb SS olduğu görüldü. HKA yöntemi ile ortalama morfin tüketimi 56.9±35.4 mg (en düşük-en yüksek/10 mg–232 mg), ortalama takip süresi 3.4±2.1 gün (en düşük-en yüksek/1–11) idi. Hastaların VAS değerleri, tedavi öncesine göre tedavi sonrasında istatistiksel olarak düşük bulundu (sırasıyla, 6.8±2.3, 0.8±0.6) (p

Patient-controlled analgesia and morphine consumption in sickle cell anemia painful crises: A new protocol

Objectives: The sudden and rapidly increasing severity of pain in sickle cell anemia painful crises frequently requires the useof strong opioids. Patients require continuous administrations of various doses (increased/decreased) within the followinghours. This study aims to retrospectively evaluate the effcts of a structured protocol based on standardized Visual AnalogueScale (VAS) and Patient-controlled analgesia (PCA) patient demand count on morphine consumption in painful crises.Methods: A total of 177 painful crises of 93 patients who were administered morphine using the PCA method according toappropriate analgesia protocol between 2004–2018 were evaluated in this study. The demographic data, hemoglobin chromatography and genotypes, painful episode follow-up time, VAS scores before and after treatment, and daily morphine consumption of the patients were recorded. Morphine consumption during the crisis according to age groups and sex were compared.Results: Of the patients, 57% were homozygous hemoglobin type SS (HbSS). Mean morphine consumption with PCA methodwas 56.9±35.4 mg (min-max: 10–232 mg) and mean follow-up time was 3.4±2.1 days (min.–max.: 1–11). VAS scores were signifiantly lower after treatment (6.8±2.3 pre-treatment; 0.8±0.6 post-treatment) (p

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