{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T03:21:54Z","timestamp":1765423314729,"version":"3.41.2"},"reference-count":45,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T00:00:00Z","timestamp":1647388800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Sickle cell disease (SCD) is a chronic illness that is associated with frequent admissions for vaso\u2010occlusive episodes (VOE). Opioids are frequently utilized in pain management, but dosing is often provider dependent. Opioids cause both short\u2010term and long\u2010term side effects, so the minimal effective dose is desired. This study examined demand\u2010only patient\u2010controlled analgesia (PCA) in pediatric patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A new clinical practice guideline (CPG) for a single institution was implemented, which eliminated basal infusion dosing for PCAs on hospital admission. The primary aim of this retrospective study was to evaluate length of stay (LOS) before and after implementation of a CPG of demand\u2010only PCA and, in a selected subpopulation, addition of short\u2010term methadone. Secondary aims included opioid utilization, acute chest syndrome (ACS), and hypoxia. Inclusion criteria included SCD, \u226421 years of age, uncomplicated VOE admission, and \u2265 3 and \u2264 8 hospital admissions for SCD pain control within one calendar year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>LOS decreased postintervention (7.2 \u00b1 5.1 vs 4.5 \u00b1 3.8 days, <jats:italic>P<\/jats:italic> &lt; 0.001). Mean total opioid utilization in morphine equivalents mg\/kg markedly decreased between the cohorts (13.3 \u00b1 33.8 vs 3.6 \u00b1 3.0, <jats:italic>P<\/jats:italic> &lt; 0.001). ACS (21.9% vs 2.8%, <jats:italic>P<\/jats:italic> = 0.004) and hypoxia (28% vs 6.9%, <jats:italic>P<\/jats:italic>&lt; 0.001) decreased significantly as well.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Bolus PCA dosing of opioids resulted in decreased LOS and reductions in opioid utilization, hypoxia, and ACS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.29665","type":"journal-article","created":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T14:01:07Z","timestamp":1647439267000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Demand\u2010only patient\u2010controlled analgesia for treatment of acute vaso\u2010occlusive pain in sickle cell disease"],"prefix":"10.1002","volume":"69","author":[{"given":"Veronica","family":"Carullo","sequence":"first","affiliation":[{"name":"Department of Anesthesiology University of Mississippi Medical Center  Jackson 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