Avaliação da analgesia de opioide tópico em úlcera de perna de paciente falcêmico

Abstract

Sickle cell disease is characterized by several clinical and pathophysiological changes including painful leg ulcers. These are difficult to heal and require the support of a multidisciplinary team in their management. The treatment of pain in these patients usually involves the use of opioids. In order to reduce the use of systemic opioids, we evaluated an easy-to-use low-cost morphine gel (0.12%) that was applied before and after changing leg ulcer dressings of sickle cell patients treated in Hemorio hospital. Based on the Analogue Pain Scale (APS) we evaluated the analgesic effect of the gel with 28 patients. All presented with a degree of pain of 7 or 8 before applying the gel. A total absence of pain was observed by 24 patients (85.7%) within thirty minutes of applying the gel, with the analgesia effect being maintained for a period of 24 hours and thus the use of other analgesics was not requiring. In 3 patients (10.7%) no pain was reported for a period of 12 hours. Only 1 patient (3.6%) reported no analgesic effect thirty minutes after the application of the gel. Our results indicate that the morphine gel was effective in controlling the pain of leg ulcers in this group of sickle cell patients. A controlled study should be designed to assess this important subject.