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Management of acute chest wall sickle cell pain with nebulized morphine
Author(s) -
Ballas Samir K.,
Viscusi Eugene R.,
Epstein Kenneth R.
Publication year - 2004
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.20064
Subject(s) - medicine , morphine , anesthesia , sickle cell anemia , acute chest syndrome , chest pain , acute pain , saline , anemia , surgery , disease
This paper describes, for the first time, the utilization of nebulized morphine in the management of severe chest pain in two young adult African‐American patients who suffered from generalized acute sickle cell painful episodes. While hospitalized, both patients developed new sharp chest wall pain, and were treated with nebulized morphine started at 20 mg MOSO 4 in 3.0‐ to 5.0‐mL physiologic buffered saline solution. Within minutes, both patients reported significant relief of chest wall pain. Patient 1 achieved 90% pain relief as well as a significant decrease in the pain intensity score. Patient 2 reported 40% pain relief, and the pain intensity score decreased to a mean of 5.6/10. Hence, treatment every 6 hr was continued for 10 days, after which the chest wall pain subsided. These findings indicate that nebulized morphine may prove effective in the management of acute chest pain in patients with sickle cell anemia. This is a desirable alternative in patients with difficult venous access and may more specifically target chest pain. Am. J. Hematol. 76:190–191, 2004. © 2004 Wiley‐Liss, Inc.