Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jun 2023
Patient-Controlled Analgesia vs Intravenous Push Hydromorphone for Pain Management of Vaso-Occlusive Crisis Associated With Sickle Cell Disease.
Patient-controlled analgesia (PCA) appears to be the preferred modality for treatment of pain associated with vaso-occlusive crisis (VOC) and is the current standard of therapy at most institutions. With limited data available, this study analyzed the effectiveness of PCA vs intravenous push (IVP) hydromorphone for pain management of VOC. The primary objective was to determine whether PCA or IVP hydromorphone is more effective in controlling VOC pain determined by a reduction in mean absolute difference pain intensity (MPI) from baseline to discharge. ⋯ The observed difference in absolute pain scores were not statistically significant (p = 0.753). The use of IVP hydromorphone resulted in a significant reduction in length of stay (LOS) and morphine milligram equivalent (MME) use compared to PCA, but was associated with a numerical increase in treatment failures. This study was limited by its retrospective nature, uneven distribution of groups, and only reviewed use of IVP and PCA hydromorphone at one institution.