Schmerztherapie bei Kindern und Jugendlichen mit Hämophilie

Stromer, Waltraud; Messerer, B.; Crevenna, Richard; Hemberger, Sophie Helene; Jauk, B.; Schwarz, Rudolf; Streif, Werner; Thom, Katharina; Wagner, Barbara; Zwiauer, Karl; Likar, Rudolf

doi:10.1007/s00482-018-0321-7

Cited by 6 publications

(3 citation statements)

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“…While general guidelines for the management of hemophilia [ 1 , 2 ] are available, there are no evidence-based guidelines or detailed algorithms that specifically deal with pain management in hemophilia patients. As far as pain management in children and adolescents with hemophilia is concerned, interdisciplinary treatment recommendations were published in 2018 [ 3 ]. An interdisciplinary group of experts (pain therapy, haematology and haemostasis, orthopaedics, paediatrics, physical medicine, psychology) has now developed recommendations for pain therapy in hemophilia patients which we present in this paper.…”

Section: Background and Goalmentioning

confidence: 99%

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Pain management in hemophilia: expert recommendations

Stromer¹,

Pabinger

et al. 2021

Wien Klin Wochenschr

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Summary Introduction As a typical consequence of bleeding into muscles and joints, patients with severe hemophilia suffer from acute and chronic pain. In spite of its high prevalence, pain in this patient group is not always sufficiently considered or treated in an effective manner. Aim The recommendations presented in this paper address possible improvements in pain management in hemophilia patients and particularities that have to be taken into account in this patient group. Method The manifold aspects of pain management in hemophilia patients were discussed within the framework of an expert meeting. Based on the available literature and the experts’ clinical experience, the participants developed a set of recommendations presented in this paper. Results Pain management in patients with hemophilia is often insufficient, a fact that not only influences the patients’ quality of life but also implies the risk of difficult to manage chronic pain. Both the prevalent polypharmacy (due to comorbidities) as well as the underlying disease itself present special challenges to pain therapy in this patient group. The present review and recommendations are intended to support medical professionals in recognising the risks of pain chronicity, applying basic principles of multimodal pain therapy, including the options of psychological intervention and modalities of physical medicine in therapy concepts, and reaching a comprehensive understanding of the range of analgesic options available.

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Section: Background and Goalmentioning

confidence: 99%

“…Children have a lower pain threshold, and the pain perception and its verbalisation strongly depend on a child’s age. An interdisciplinary expert panel developed recommendations to improve pain management in children and adolescents with hemophilia [ 3 ].…”

Section: Particularities In Children and Adolescentsmentioning

confidence: 99%

Pain management in hemophilia: expert recommendations

Stromer¹,

Pabinger

et al. 2021

Wien Klin Wochenschr

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“…Little is known about the underlying mechanism of altered PPT and the relationship with everyday pain, 32,33 especially in asymptomatic joints of this young population. In our study, the complex subject of pain was not taken into consideration other than the measured PPT.…”

Section: Ta B L E 1 Characteristics Of Participantsmentioning

confidence: 99%

The effect of age on the pressure pain threshold of asymptomatic ankles and knees in young individuals with haemophilia

et al. 2021

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Introduction Despite adequate medical treatment, many young adults with haemophilia develop joint alterations—especially in ankles and knees. Undetected over years, subtle structural changes cause subclinical symptoms, before problems become obvious. To objectify these silent pressure pains, the pressure pain threshold (PPT) can be measured by algometry. Aim The aim was to investigate and compare the effect of age on PPTs in asymptomatic ankles and knees between boys and young adults with haemophilia and age‐matched controls, in order to gain better knowledge about the alteration of the periarticular structures with increasing age. Material and methods Nineteen persons with haemophilia (PwH; severe or moderate; 8–30 years) and 19 age‐matched controls with ‘healthy’ ankles and knees were recruited. Asymptomatic joints with a Haemophilia Joint Health Score = 0 were included. The PPT was measured on four periarticular points per joint, and the data were analysed with a linear mixed model. Results The PPT of the control group increased with age, whereas the PPT of the PwH decreased. The difference in age effect per year in kPa between PwH and controls was as follows: β [95%‐CI]: −15.41 [−31.63; 0.79]. Although the result was not statistically significant (p = .08), a clear tendency was shown. Conclusion The results suggest that subclinical alterations in the periarticular structures of these joints may evolve unnoticed over time. However, further research is warranted to determine whether this observed trend is confirmed in a larger sample and at what age the PPT begins to decrease in PwH compared to controls.

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