Publications by authors named "Becky B Wright"

5 Publications

  • Page 1 of 1

Prospective randomized trial of interventions for vincristine-related neuropathic pain.

Pediatr Blood Cancer 2020 09 2;67(9):e28539. Epub 2020 Jul 2.

Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee.

Background: To evaluate the efficacy of gabapentin at 20 mg/kg per day in the treatment of vincristine-related neuropathic pain.

Procedure: Children aged 1-18 years who developed vincristine-induced neuropathy on a St Jude frontline acute lymphoblastic leukemia trial were prospectively enrolled on a randomized, double-blind, placebo-controlled, phase II trial with two treatment arms: gabapentin plus opioid versus placebo plus opioid. Daily evaluations of morphine dose (mg/kg per day) and pain scores were conducted for up to 21 days; the values of the two arms were compared to assess analgesic efficacy.

Results: Of 51 study participants, 49 were eligible for analyses. Twenty-five participants were treated with gabapentin, with a mean (SD) dose of 17.97 (2.76) mg/kg per day (median 18.26, range 6.82-21.37). The mean (SD) opioid doses taken, expressed as morphine equivalent daily (mg/kg per day), were 0.26 (0.43) in the gabapentin group (25 patients, 432 days) and 0.15 (0.22) in the placebo group (24 patients, 411 days; P = .15). Only the risk classification of acute lymphoblastic leukemia was significantly associated with the daily morphine dosage (P = .0178): patients in the lower risk arm received higher daily morphine dosages. Multivariate analyses revealed a significant difference between the groups' average daily scores for the previous 24 h and "right now."

Conclusion: In this population of children with vincristine-related neuropathic pain, opioid consumption and pain scores were higher in the gabapentin group than in the placebo group. Future randomized, double-blind, placebo-controlled studies should test gabapentin given longer or at a higher dose.
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http://dx.doi.org/10.1002/pbc.28539DOI Listing
September 2020

A neck burn of unexpected etiology during magnetic resonance imaging of a one year old boy.

J Clin Anesth 2014 Feb 18;26(1):86-7. Epub 2014 Jan 18.

Department of Children's Anaesthesia, Women's and Children's Hospital, North Adelaide, SA 5006, South Australia. Electronic address:

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http://dx.doi.org/10.1016/j.jclinane.2013.08.003DOI Listing
February 2014

A randomized controlled trial comparing the AccuVein AV300 device to standard insertion technique for intravenous cannulation of anesthetized children.

Paediatr Anaesth 2012 Sep 14;22(9):884-9. Epub 2012 Jun 14.

Department of Anesthesiology, American University of Beirut, Beirut, Lebanon.

Objectives And Aims: To evaluate the efficacy of the AccuVein AV300 device in improving the first-time success rate of intravenous cannulation of anesthetized pediatric patients.

Background: The AccuVein AV300 device was developed to assist venepuncture and intravenous cannulation by enhancing the visibility of superficial veins. It uses infrared light to highlight hemoglobin so that blood vessels are darkly delineated against a red background.

Methods/materials: Patients were randomized to cannulation with the AccuVein AV300 device or standard insertion by experienced pediatric anesthesiologists. An observer recorded the number of skin punctures and cannulation attempts required, and the time between tourniquet application and successful cannulation or four skin punctures, whichever came first.

Results And Conclusions: There were 146 patients with a median age of 4.6 years (range, 0.18-17.1 years), 46.6% were male, 80.8% were light skin colored, and 15.7% were younger than 2 years. The first-attempt success rates were 75% (95% CI, 63.8-84.2%) using AV300 and 73% (95% CI, 61.9-81.9%) using the standard method (P = 0.85). Patients with dark or medium skin color were 0.38 times less likely to have a successful first attempt than patients with light skin color. The difference between the two treatment groups in number of skin punctures and the time to insertion was not significant. Although the AV300 was easy to use and improved visualization of the veins, we found no evidence that it was superior to the standard method of intravenous cannulation in unselected pediatric patients under anesthesia.
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http://dx.doi.org/10.1111/j.1460-9592.2012.03896.xDOI Listing
September 2012

Risk of catheter-associated infection in young hematology/oncology patients receiving long-term peripheral nerve blocks.

Paediatr Anaesth 2012 Nov;22(11):1110-6

Division of Anesthesia and Pain Management Service, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.

Background: Continuous peripheral nerve blocks (CPNBs) are increasingly used to control postoperative and chronic pain. At our pediatric oncology institution, the duration of CPNBs is often prolonged. The risk of catheter-associated infection with prolonged CPNBs has not been previously investigated.

Aim: We analyzed the incidence of CPNB-related infection and its relation to catheter duration, catheter site, intensive care stay, and antibiotic coverage.

Methods: All CPNBs placed at our institution between August 1, 2005 and October 31, 2010 were studied. Primary diagnosis and the site, indication, duration, and infectious adverse effects of CPNBs were obtained from our Pain Service QI database. Patients' age and sex, antibiotic administration, and number of days in intensive care were collected from patients' medical records.

Results: The use of 179 catheters in 116 patients was evaluated. Mean age at CPNB placement was 15.1 years (median, 14.7; range, 0.4-26.9). The most frequent indication for CPNB was surgery (89.4%), most commonly orthopedic (78.8%). Mean CPNB duration was 7.2 days (median, 5.0; range, 1-81 days). Two cases (1.12%) of CPNBs developed signs of infection, both associated with femoral catheters. The infections were mild and necessitated catheter removal at days 10 and 13, respectively.

Conclusion: Nerve block catheter-associated infections are infrequent at our institution despite prolonged CPNB use. Both patients with infection had femoral catheters and prolonged catheter (≥ 10 days) use.
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http://dx.doi.org/10.1111/j.1460-9592.2012.03880.xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3422424PMC
November 2012

Phantom limb pain in young cancer-related amputees: recent experience at St Jude children's research hospital.

Clin J Pain 2012 Mar-Apr;28(3):222-5

Department of Children's Anaesthesia, Women's and Children's Hospital, Adelaide, Australia.

Objectives: This study in children and young adults having cancer-related amputation aimed to examine the incidence of phantom limb pain (PLP) in the first year after amputation and also the proportion of patients who had preamputation pain.

Methods: A retrospective review of medical records was undertaken. The proportion of patients with PLP was reported. Fisher exact test was used to examine the association between PLP and the presence of preamputation pain and between PLP and age (≤ 18 y vs. >18 y).

Results: Twenty-six amputations were performed on 25 patients. During the year after amputation, 76% of patients had experienced PLP at some time. After 1 year, though, only 10% still had PLP. Preamputation pain was present in 64% of patients. Although both of our patients with PLP at 1 year were young adults (older than or equal to 18 y) and both had preamputation pain, we found no statistically significant associations between age or the presence of preamputation pain with PLP.

Discussion: PLP after cancer-related amputation in children and young adults seems to be common but generally short lived in most patients.
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http://dx.doi.org/10.1097/AJP.0b013e318227ce7aDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3742300PMC
June 2012