Sickle Cell, Sickle Cell Disease, Vaso-Occlusive Crises
Conditions
Keywords
Loco-regional anesthesia, inflammation, Vaso-Occlusive Crises
Brief summary
Sickle cell disease is a chronic disease characterized by multiple vaso-occlusive complications. The basic treatment for patients with a vaso-occlusive crisis (VOC) is based on adequate hydration, oxygen therapy and pain control. Loco Regional Anesthesia (LRA) is one of the major treatments in resuscitation anesthesia for both anesthesia and analgesia. LRA allows effective and almost immediate pain control by blocking nerve afferents in a given area. LRA could decrease the inflammatory response during crises and accelerate resolution of the crisis.
Detailed description
Regional anesthesia (RA) possesses intrinsic anti-inflammatory properties and can modulate the inflammatory response. For instance, ropivacaine reduces inflammation induced in vitro in rat epithelial cells. At the cellular level, lidocaine decreases free radical production by neutrophils, inhibits leukocyte phagocytic activity, and significantly suppresses cytokine production in response to endotoxemia. The value of RA no longer lies solely in its ability to block nociceptive input via sodium channel inhibition. A peripheral nerve block with local anesthetics inhibits local neurogenic inflammation, thereby reducing sensitization, hyperalgesia, and the risk of pain chronification. A peripheral nerve block is therefore an anti-inflammatory treatment. However, no study has yet demonstrated the anti-inflammatory effects of RA at the cellular level in sickle cell disease patients. The aim of this study is to analyze the evolution of inflammatory markers during vaso-occlusive crises (e.g., MPs, cytokines, NETs, etc.), by comparing patients who received RA to those who did not during hospitalization.
Interventions
None listed
Sponsors
Centre Hospitalier Universitaire de la Guadeloupe
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* patients adult \>18 years * patients with vaso-occlusive crisis
Exclusion criteria
* Pregnant or breastfeeding women * Blood transfusion within the last 3 months * Lack of affiliation with the French social security system * Protected individuals
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Inflammatory process during vaso-occlusive crises | Baseline and Day 1 | The variation between D0 and D1 in the proportion of endothelial cells expressing ICAM-1 on their surface, following stimulation with microparticles from patients who received or did not receive regional anesthesia. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quantification of protein levels | Baseline and day 1 | ICAM-1, VCAM-1, P-selectin, Elastase (marker of neutrophil extracellular traps (NET) |
| Quantification of cytokine levels | Baseline and day 1 | Quantification of cytokine levels |
| Quantitative and qualitative profil of blood microparticles | Baseline and day 1 | Quantitative and qualitative profil of blood microparticles |
Countries
Guadeloupe
Contacts
Primary ContactValérie Hamony Soter
Backup ContactMélanie Petapermal
Outcome results
None listed