Article Text

other Versions

PDF
Intranasal diamorphine for acute sickle cell pain
  1. Paul Trevor Telfer (paul.telfer{at}bartsandthelondon.nhs.uk)
  1. Barts and The London School of Medicine and Dentistry, United Kingdom
    1. Carolina Lahoz (carolahoz{at}hotmail.com)
    1. Barts and The London NHS Trust, United Kingdom
      1. Kamal Ali (kamalali73{at}yahoo.com)
      1. Childrens Hospital, Barts and The London NHS Trust, United Kingdom
        1. Samu Pekwa (samu.pekwa{at}aol.com)
        1. Childrens Hospital, Barts and The London NHS Trust, United Kingdom
          1. Yvonne John (yvonne.john{at}bartsandthelondon.nhs.uk)
          1. Childrens Hospital, Barts and The London NHS Trust, United Kingdom
            1. John Criddle (john.criddle{at}gstt.nhs.uk)
            1. Paediatric Emergency Medicine, Guys and St Thomas NHS Foundation Trust, United Kingdom
              1. Julian Sandell (juliansandell{at}hotmail.com)
              1. Poole General Hospital, United Kingdom
                1. Ffion Davies (ffion.davies{at}doctors.org.uk)
                1. Emergency Medicine, Leicester Royal Infirmary, United Kingdom
                  1. Ian Morrison (ian.morrision{at}bartsandthelondon.nhs.uk)
                  1. Childrens Hospital, Barts and The London NHS Trust, United Kingdom
                    1. Joanne Challands (joanne.challands{at}bartsandthelondon.nhs.uk)
                    1. Childrens Hospital, Barts and The London NHS Trust, United Kingdom

                      Abstract

                      The painful crisis is the commonest acute presentation of sickle cell disease (SCD), yet effective pain control in hospital is often delayed, inadequate and dependent on injected opiates. Intranasal diamorphine (IND) has been used in paediatric emergency departments for management of acute pain associated with fractures, but the analgesic effect is short-lived. We evaluated its efficacy and safety when given in combination with intravenous or oral morphine for rapid analgesia for children presenting to our emergency department with painful crisis of SCD. In phase one, nine patients received IND plus intravenous morphine. In phase two, thirteen received IND plus oral morphine. There was a rapid improvement in pain score, the proportions in severe pain at t=0,15,30 and 120 minutes in Phase 1 were 78%, 11%, 0% and 11%; in Phase 2 , 77%, 30%,15% and 0%. There were no serious side effects and questionnaire scores indicated that children found IND effective and acceptable. IND can be recommended for acute control of sickle pain in children presenting to hospital.

                      Statistics from Altmetric.com

                      Request permissions

                      If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.