Browse Items · Pediatric Palliative Care Library

The double effect of pain medication: separating myth from reality

The principle of double effect is used to justify the administration of medication to relieve pain even though it may lead to the unintended, although foreseen, consequence of hastening death by causing respiratory depression. Although a review of…

Tags: 1998, Analgesics, Assisted, Backlog, Death and Euthanasia, Double Effect Principle, Euthanasia, Fohr SA, Humans, Intention, Journal Article, Journal of Palliative Medicine, Opioid/adverse effects/therapeutic use, Pain/drug Therapy, Palliative Care/ethics, Refusal to Treat, Respiratory Insufficiency/chemically induced, Suicide

Occurrence of withdrawal in critically ill sedated children

OBJECTIVES: To record the number of children with withdrawal symptoms after the administration of sedatives for mechanical ventilation, and to discuss the possible connection with the administration of midazolam. DESIGN: Retrospective data collection…

The management of pain in children with life-limiting illnesses

The management of pain in children with life-limiting illnesses is complex and unfortunately not often done effectively. Pain is a multidimensional symptom that can overshadow all other experiences of both the child and family. This article focuses…

Opioids for chronic noncancer pain: a new Canadian practice guideline

2010

Tags: 2010, Advisory Committees/organization & administration, Analgesics, Backlog, Canada, Canadian Medical Association Journal, Chronic Disease, Furlan AD, Humans, Journal Article, National Opioid Use Guideline Group, Opioid/administration & dosage/adverse effects/therapeutic use, Pain/drug Therapy, Practice Guidelines As Topic, Reardon R, Weppler C

Recognition and management of iatrogenically induced opioid dependence and withdrawal in children

Opioids are often prescribed to children for pain relief related to procedures, acute injuries, and chronic conditions. Round-the-clock dosing of opioids can produce opioid dependence within 5 days. According to a 2001 Consensus Paper from the…

Tags: 2014, American Academy of Pediatrics, Analgesics, Backlog, Child, Committee on Drugs, Galinkin J, Humans, Iatrogenic Disease, Journal Article, Koh JL, Opioid, Opioid-Related Disorders, Pain Medicine, Pediatrics, Section On Anesthesiology, Substance Withdrawal Syndrome, United States

Analgesic effects of topical methadone: a report of four cases

Topical morphine has been used on open wounds for pain management, but has a variable duration of action not suitable for palliative dressing changes. The objective of this study is to find an opioid and delivery method that would provide…

Pain and symptom control in terminally ill children

The management of pain in terminally ill pediatric patients has incalculable benefits to patients, their families, and physicians and nurses. A therapeutic management plan is dependent on a thorough understanding of the causes of pain in these…

The efficacy and side effects of continuous infusion intravenous morphine (CIVM) for pain and symptoms due to advanced cancer

Morphine is the strong opioid of choice in the management of moderate-to-severe chronic cancer pain. The preferred route of administration is oral, in individually titrated doses, regularly scheduled around the clock We conducted a retrospective…

Interaction of serotonergic antidepressants and opioid analgesics: Is serotonin syndrome going undetected?

OBJECTIVES: To describe the potential for interaction between opioids and serotonergic antidepressants leading to the development of serotonin syndrome (SS), mechanism of the interaction, and the spectrum of SS in elderly residents of a long-term…

Pediatric acute pain management

The past decade has brought about an explosion of knowledge about the physiology of nociception and many new techniques for pain relief, new analgesic drugs, and new applications of old analgesic drugs. These techniques include methods of opioid…

Prospective audit of short-term concurrent ketamine, opioid and anti-inflammatory ('triple-agent') therapy for episodes of acute on chronic pain

AIM: This prospective audit was undertaken in order to document the analgesic response and adverse effects of concurrent short-term ('burst') triple-agent analgesic (ketamine, an opioid and an anti-inflammatory agent--either steroidal or…

Comparative clinical efficacy and safety of a novel controlled-release oxycodone formulation and controlled-release hydromorphone in the treatment of cancer pain

BACKGROUND: The use of oxycodone to treat chronic cancer pain has been hampered by its short elimination half-life, which necessitates administration every 4 hours. This study compared the clinical efficacy and safety of a novel oxycodone formulation…

Tags: 1997, Analgesics, Babul N, Backlog, Cancer, Comparative Study, Cross-Over Studies, Delayed-Action Preparations, Double-Blind Method, Drug Evaluation, Female, Hagen NA, Humans, Hydromorphone/administration & Male, Journal Article, Middle Aged, Neoplasms/complications, Opioid/administration & dosage, Oxycodone/administration & Pain/drug therapy

Strong opioids in pediatric palliative medicine

2005

Tags: 2005, Analgesics, Backlog, Devins M, early research in children does suggest some significant differences in opioid pharmacokinetics, Hain RD, illustrated by the WHO guidelines, is essential for the adequate management of pain complicating the palliative phase in children with life-limiting conditions., Journal Article, Miser A, much of what has been published regarding the management of pain in palliative medicine in adults can be extrapolated. On saying that, Opioid/administration & dosage/adverse effects/therapeutic use Child Child, Paediatr Drugs, particularly with respect to morphine clearance, PedPal Lit, Preschool Half-Life Humans InfantMorphine/adverse effects/pharmacokinetics/therapeutic use Pain/classification/drug therapy Palliative Care/methods Tissue Distribution, the use of opioids in pediatric palliative care presents some unique challenges. Confident and rational use of o pioids by pediatricians, unsuitable for use in children, Wallace WH, which seems to be faster in adults. Thus

Morphine and alternative opioids in cancer pain: the EAPC recommendations

An expert working group of the European Association for Palliative Care has revised and updated its guidelines on the use of morphine in the management of cancer pain. The revised recommendations presented here give guidance on the use of morphine…

Influence of pain treatment by epidural fentanyl and bupivacaine on homing of opioid-containing leukocytes to surgical wounds

Endogenous opioids released from leukocytes extravasating into injured tissue can interact with peripheral opioid receptors to inhibit nociception. Animal studies have shown that the homing of opioid-producing leukocytes to the injured site is…

Tags: 2007, Adjuvants, Aged, Analgesia, Analgesics, Anesthesia, Anesthesia/immunology/pharmacology, Anesthetics, Backlog, beta-Endorphin/drug effects/immunology/metabolism, Biomarkers of Pain, Brain, Behavior, And Immunity, Bupivacaine/immunology/therapeutic use, Cell Movement/drug effects/immunology, Enkephalin, Epidural, Female, Fentanyl/immunology/therapeutic use, Heurich M, Humans, Journal Article, Kopf A, Lenzner M, Leukocytes/drug effects/immunology/metabolism, Local/immunology/therapeutic use, Longitudinal Studies, Male, Methionine/drug effects/immunology/metabolism, Middle Aged, Morciniec P, Mousa SA, Nociceptors/drug effects/immunology, Opioid/immunology/therapeutic use, Pain, Patient-Controlled, Pirinitramide/therapeutic use, Postganglionic/drug effects/immunology, Postoperative/immunology/prevention & control, Stein C, Subcutaneous Tissue/immunology, Sympathetic Fibers, Welte M, Wound Healing/drug effects/immunology

Opioid use in palliative care of children and young people with cancer

OBJECTIVE: Identify opioids prescribed, preferred routes, and doses among children with incurable cancer. STUDY DESIGN: Prospective survey with monthly questionnaires regarding patients 0 to 19 years old from oncology centers. Data were collected by…

Can end of life care for the pediatric patient suffering with escalating and intractable symptoms be improved?

Over twelve thousand children are diagnosed each year with cancer, and approximately 2200 children die each year from the disease. A percentage of these patients experiences escalating and intractable distress with symptoms that include pain,…

Tags: 2006, Analgesics, Backlog, Branowicki PA, Dinning C, Houlahan KE, Journal Article, Journal Of Pediatric Oncology Nursing, Mack JW, McCabe M, Opioid/therapeutic use Boston ChildClinical Protocols Humans Neoplasms/nursing Pain/drug therapyPalliative Care/methods/organization & administration Pilot Projects Practice Guidelines, PedPal Lit

Transdermal fentanyl for pain relief in a paediatric palliative care population

This multicentre, observational study examined the efficacy of the therapeutic transdermal fentanyl system (TTS-fentanyl) in children requiring opioids for pain in life-threatening disease. Forty-one children receiving oral morphine (median dose 60…

Population pharmacokinetics of oral morphine and its glucuronides in children receiving morphine as immediate-release liquid or sustained-release tablets for cancer pain

OBJECTIVES: (1) To determine the pharmacokinetics of morphine, morphine-6-glucuronide (M6G), and morphine-3-glucuronide (M3G) in children with cancer receiving morphine as immediate-release morphine liquid or sustained-release tablets. (2) To…

Transdermal fentanyl. A review of its pharmacological properties and therapeutic efficacy in pain control

Fentanyl is a synthetic opioid with short-acting analgesic activity after intravenous or subcutaneous administration. The low molecular weight, high potency and lipid solubility of fentanyl make it suitable for delivery via the transdermal…

Tags: 1997, Analgesics, Backlog, Benfield P, Drugs, Fentanyl/administration & dosage/adverse effects/pharmacokinetics, Humans, Jeal W, Journal Article, Opioid/administration & dosage, Pain/drug Therapy

Recommendations for using opioids in chronic non-cancer pain

1. The management of chronic pain should be directed by the underlying cause of the pain. Whatever the cause, the primary goal of patient care should be symptom control. 2. Opioid treatment should be considered for both continuous neuropathic and…

Opioids in chronic non-cancer pain: systematic review of efficacy and safety

Opioids are used increasingly for chronic non-cancer pain. Controversy exists about their effectiveness and safety with long-term use. We analysed available randomised, placebo-controlled trials of WHO step 3 opioids for efficacy and safety in…

Analgesic effect of the synthetic cannabinoid CT-3 on chronic neuropathic pain: a randomized controlled trial

CONTEXT: 1',1'dimethylheptyl-Delta8-tetrahydrocannabinol-11-oic acid (CT-3), a potent analog of THC-11-oic acid, produces marked antiallodynic and analgesic effects in animals without evoking the typical effects described in models of cannabinoids.…

Patients with malignant hematological disorders treated on a palliative care unit: prognostic impact of clinical factors

A reliable estimation of prognosis in patients receiving palliative care is desirable in order to facilitate clinical decision finding. For patients with advanced hematological malignancies, only few data are available to estimate prognosis of the…

Intravenous morphine for emergency treatment of cancer pain

Despite the wide use of the World Health Organization (WHO) analgesic ladder for the relief of cancer pain, it is not uncommon to find patients presenting with severe pain to palliative care centres. This is more so in the developing world, where…

Biological rhythms in pain and in the effects of opioid analgesics

Pain is difficult and sometimes frustrating to treat, even though new devices and new approaches have been developed in recent years. Pain varies tremendously from one patient to the next, and there are also some studies suggesting that the intensity…

Tags: 1995, Analgesics, Animals, Backlog, Circadian Rhythm/drug effects/physiology, Humans, Journal Article, Labrecque G, Opioid/administration & dosage/therapeutic use, Pain/drug therapy/physiopathology, Pharmacology & Therapeutics, Vanier MC

A Descriptive Report Of End-of-life Care Practices Occurring In Two Neonatal Intensive Care Units

BACKGROUND:
In Canada and other developed countries, the majority of neonatal deaths occur in tertiary neonatal intensive care units. Most deaths occur following the withdrawal of life-sustaining treatments.
AIM:
To explore neonatal death events and…

Clinical use of methadone

Methadone hydrochloride is a mu-opioid agonist that has been used for the treatment of pain and for the management and maintenance of opioid withdrawal for over 50 years. Several characteristics make methadone a useful drug. However, these same…

Chronic pain management and the surgeon: barriers and opportunities

Postoperative epidural analgesia with bupivacaine and fentanyl: hourly pain assessment in 348 paediatric cases

BACKGROUND: The objective of this prospective study was the evaluation of the analgesia provided by an epidural infusion of bupivacaine and fentanyl after different types of surgery in children. METHODS: Data were collected from 348 epidural…

Increased numbers of opioid expressing inflammatory cells do not affect intra-articular morphine analgesia

BACKGROUND: Both locally expressed beta-endorphin (END) and low doses of morphine relieve pain within inflamed knee joints. Here we examined whether enhanced inflammation and END expression within the synovial tissue of patients undergoing…

A review of the use of methadone for the treatment of chronic noncancer pain

Methadone, although having been available for approximately half a century, is now receiving increasing attention in the management of chronic pain. This is due to recent research showing that methadone exhibits at least three different mechanisms of…

Tags: 2005, Analgesics, Backlog, Canada, Chronic Disease, Drug, Humans, Journal Article, Legislation, Lynch ME, Methadone, Methadone/adverse effects/chemistry/pharmacokinetics/pharmacology/therapeutic use, Non-U.S. Gov't, Opioid/adverse effects/chemistry/pharmacokinetics/pharmacology/therapeutic use, Pain Research & Management : The Journal Of The Canadian Pain Society = Journal De La Societe Canadienne Pour Le Traitement De La Douleur, Pain/drug Therapy, Research Support

Pain control by immune-derived opioids

1. The nervous and immune systems communicate with each other by use of cytokines and neuropeptides. 2. Interactions between immune cell-derived opioid peptides and opioid receptors located in peripheral inflamed tissue lead to endogenous analgesia.…

Tags: 2000, Analgesics, Backlog, Biomarkers of Pain, Clinical And Experimental Pharmacology & Physiology, Humans, Journal Article, Machelska H, Neuropeptides/therapeutic use, Opioid/drug effects/immunology, Opioid/therapeutic use, Pain/drug therapy/immunology, Peripheral Nervous System/drug effects, Receptors, Stein C

Immune mechanisms in pain control

2002

Tags: 2002, Analgesics, Anesthesia & Analgesia, Animals, Backlog, Cellular/physiology, Endorphins/metabolism, Humans, Immune System/physiology, Immunity, Journal Article, Machelska H, Non-U.S. Gov't, Opioid/pharmacology, Opioid/physiology, Pain/drug therapy/immunology/pathology, Receptors, Research Support, Stein C

Browse Items (131 total)