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Colegio de Medicos y Cirujanos República de Costa Rica

2011, Number 597

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Rev Med Cos Cen 2011; 68 (597)

Manejo del dolor en la drepanocitosis

Carvajal VG, Díaz AA, Chacón PL

Language: Spanish
References: 22
Page: 229-234
PDF size: 334.54 Kb.


ABSTRACT

Sickle cell disease includes a group of genetically inherited disorders in which at low oxygen saturation there is aggregation of rigid polymers of deoxygenated hemoglobin S, giving the erythrocyte a sickle shape and damaging the vascular endothelium by multiple mechanisms, and concomitantly obstructing microcirculation and stimulating nociceptors. Patients with sickle cell disease may have multiple types of pain depending on the injured structures, being musculoskeletal type the most often. The basis for the management of pain is recognition and evaluation of the severity, on which will depend the prescription of analgesic treatment. Vaso-occlusive crises are the most characteristic manifestation of this disease. Once the pain is onset, the initial management must focus on providing rapid control, ensuring therapeutic doses of drugs, and detection of complications. Not indicated use of therapies and subtherapeutic treatment should be avoided, accompanied of a careful monitoring, prevention and treatment of adverse effects. The treatment of chronic pain is multidisciplinary, and non-pharmacological strategies should be considered.


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