Use of Patient-controlled Analgesia for Pain Control in Dying Children

Overview

Journal Support Care Cancer

Specialties Critical Care
Oncology

Date 2008 Feb 16

PMID 18274785

Citations 12

Authors

Christine Schiessl

Chara Gravou

Boris Zernikow

Reinhard Sittl

Norbert Griessinger

Affiliations

Soon will be listed here.

Abstract

Background: In the last week of life, the daily opioid dose in children is highly variable, making the use of patient-controlled analgesia (PCA) a useful therapy option. Scientific data on the use of PCA in paediatric palliative care are rare.

Materials And Methods: Retrospective chart review over a 7-year period (Jan 1998-Jan 2005) of PCA treated children dying of cancer was used.

Results: Eight children were on PCA for a median duration of 9 days (range, 1 to 50). The daily median intravenous morphine equivalent dose referenced to body weight increased significantly when PCA was initiated and during the last week of life. In the last week of life, the median daily number of delivered and undelivered bolus requests ranged from 7.5-21 and 0-4.5, respectively. To meet children's individual needs, 39 PCA parametre changes on 22 opportunities were performed. Median daily mean pain scores remained low (range, 0-3; numerical rating scale 0-10) throughout the period.

Conclusion: PCA proved an ideal, dependable and feasible mode of analgesic administration for the individual titration of dose to effect.

Citing Articles

A Narrative Review of Pain in Pediatric Oncology: The Opioid Option.

Hall E, Hagemann T, Shelton C, Jasmin H, Calvasina A, Anghelescu D Paediatr Drugs. 2024; 26(5):565-596.

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Alleviating Terminal Pediatric Cancer Pain.

Moody K, Baig M, Carullo V Children (Basel). 2021; 8(3).

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Healthcare interventions improving and reducing quality of life in children at the end of life: a systematic review.

Piette V, Beernaert K, Cohen J, Pauwels N, Scherrens A, Van Der Werff Ten Bosch J Pediatr Res. 2020; 89(5):1065-1077.

PMID: 32645707 DOI: 10.1038/s41390-020-1036-x.

Documentation of breakthrough pain in narrative clinical records of children with life-limiting conditions: Feasibility of a retrospective review.

Oostendorp L, Rajapakse D, Kelly P, Crocker J, Dinsdale A, Fraser L J Child Health Care. 2018; 23(4):564-578.

PMID: 30463428 PMC: 7323830. DOI: 10.1177/1367493518807312.

Subcutaneous or intravenous opioid administration by patient-controlled analgesia in cancer pain: a systematic literature review.

Nijland L, Schmidt P, Frosch M, Wager J, Hubner-Mohler B, Drake R Support Care Cancer. 2018; 27(1):33-42.

PMID: 30056529 DOI: 10.1007/s00520-018-4368-x.

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