New sickle cell anemia therapy findings from E.J. van Beers and co-researchers published
2007 NOV 19 -- Researchers detail in 'Patient-controlled analgesia versus continuous infusion of morphine during vaso-occlusive crisis in sickle cell disease, a randomized controlled trial,' new data in sickle cell anemia. According to a study from Amsterdam, Netherlands, "Intravenous morphine is the treatment of choice for severe pain during vaso-occlusive crisis in sickle cell disease (SCD). However, side effects of morphine may hamper effective treatment, and high plasma levels of morphine are associated with severe complications such as acute chest syndrome." "Furthermore, adequate dosing remains a problem since no objective measurement of pain severity exists and analgesia should be titrated upon the patient's reported pain. Patient-controlled analgesia (PCA) may therefore be an interesting alternative since patients can titrate the level of analgesia themselves. In this randomized controlled study, the efficacy of intravenous morphine administration with PCA was compared with continuous infusion (CI) of morphine in patients with SCD during vaso-occlusive crisis. Twenty five consecutive episodes of vaso-occlusive crisis in 19 patients with SCD were included in the study. Patients in the PCA-group had a markedly and significant lower mean and cumulative morphine consumption when compared with the patients in the CI-group (0.5 mg/hr versus 2.4 mg/hr (p <0.001) and 33 mg versus 260 mg (p=0.018, respectively). The mean daily pain scores were comparable (4.9 versus 5.3). The lower mean and cumulative morphine consumption in the PCA-group led to significant less nausea and constipation during treatment when compared with the CI-group (area under the curve, respectively, 11 versus 18 (p=0.045) and 30 versus 45 (p=0.021). Furthermore, a nonsignificant reduction in the duration of hospital admission of 3 days was observed in the PCA-group," wrote Beers E.J. van and colleagues, . The researchers concluded: "PCA results in adequate pain relief at a much lower morphine consumption and should considered to be the first choice in morphine administration to sickle cell patients admitted with vaso-occlusive crisis." van and colleagues published the results of their research in American Journal of Hematology (Patient-controlled analgesia versus continuous infusion of morphine during vaso-occlusive crisis in sickle cell disease, a randomized controlled trial. American Journal of Hematology, 2007;82(11):955-60). For additional information, contact E.J. van Beers, Academic Medical Centre, Dept. of Hematology, Amsterdam, Netherlands. The publisher of the American Journal of Hematology can be contacted at: Wiley-Liss, Division John Wiley & Sons Inc., 111 River St., Hoboken, NJ 07030, USA. Keywords: Netherlands, Amsterdam, Sickle Cell Anemia Therapy, Analgesic, Clinical Trial Research, Hematology, Morphine, Narcotic, Opiate Agonist, Sickle Cell Anemia, Sickle Cell Disease, Therapy, Treatment. This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2007, Biotech Business Week via NewsRx.com.
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