A comparison of two regimens of patient-controlled analgesia for children with sickle cell disease.

Recently, patient controlled analgesia (PCA) has gained prominence in the treatment of pain for children suffering from vaso-occlusive crisis associated with sickle cell disease. Because there are several different regimens that can be used for PCA, the purpose of this study was to compare and contrast two regimens of patient controlled analgesia (PCA) in terms of safety, efficacy, and cost for the treatment of vaso-occlusive pain associated with sickle cell disease. In this study a retrospective chart review was conducted. The charts of 26 children, hospitalized on 60 different occasions in which PCA was used in the treatment of vaso-occlusive disease were included in the final sample. Patients were grouped according to the type of PCA regimen they received: high dose PCA/low basal infusion (HPCA/LBI) or low dose PCA/high basal infusion (LPCA/HBI). Children in Group 1 (HPCA/LBI) used significantly less morphine during their hospitalization, were hospitalized fewer days, and reported lower pain scores on day 2. There were considerable cost savings due to decreased length of stay, less morphine consumed overall, and fewer days required for rental of the PCA pump.