Browse Items · Pediatric Palliative Care Library

The challenge of preemptive analgesia

2005

Tags: 2005, Adult, Aida S, Analgesia, Analgesics, Anesthesia, Backlog, Journal Article, Pain, Pain: Clinical Updates, Preoperative Care

Acetaminophen toxicity in children

Acetaminophen is widely used in children, because its safety and efficacy are well established. Although the risk of developing toxic reactions to acetaminophen appears to be lower in children than in adults, such reactions occur in pediatric…

Tags: 2001, Acetaminophen/adverse effects/poisoning/therapeutic use, Adult, Age Factors, American Academy of PediatricsCommittee on Drugs, Analgesics, Backlog, Charcoal/therapeutic use, Child, Humans, Ibuprofen/therapeutic use, Journal Article, Non-Narcotic/adverse effects/poisoning/therapeutic use, Overdose/diagnosis/therapy, Pediatrics

Pain, sedation and morphine metabolism in cancer patients during long-term treatment with sustained-release morphine

BACKGROUND: Morphine-6-glucuronide (M-6-G) and morphine-3-glucuronide (M-3-G) are the two most important metabolites of morphine. Both are pharmacologically active, however, with different effects. M-6-G has been demonstrated capable of inducing…

Opioid dependence and addiction during opioid treatment of chronic pain

Throughout the long history of opioid drug use by humans, it has been known that opioids are powerful analgesics, but they can cause addiction. It has also been observed, and is now substantiated by multiple reports and studies, that during opioid…

Tags: 2007, Analgesics, Backlog, Ballantyne JC, Brain/drug effects/physiopathology, Chronic Disease, Humans, Journal Article, LaForge KS, Models, Neurological, Opioid-Related Disorders/etiology/physiopathology/prevention & control, Opioid/adverse effects/therapeutic use, Pain, Pain/drug therapy/physiopathology/psychology, Physician's Practice Patterns/trends

Use of analgesic agents for invasive medical procedures in pediatric and neonatal intensive care units

The purpose of this study was to assess the use of analgesic agents for invasive medical procedures in pediatric and neonatal intensive care units. The directors of 38 pediatric units and 31 neonatal units reported that analgesics were infrequently…

Pediatric sedation with analgesia

Sedation with analgesia is frequently required to perform painful or invasive procedures in children. The best medication combination for pediatric sedation with analgesia is yet to be identified. Sixty-four of 243 total sedation with analgesia…

The use of an intrathecal pump to manage intractable cancer pain in a pediatric patient: a case report

A 15-year-old girl with combined immune deficiency syndrome, diagnosed with metastatic squamous cell cancer of the anus, had significant pain secondary to vulvar-perianal condyloma. Conventional treatment with oral and intravenous analgesics was…

Analgesics for the treatment of pain in children

Pharmacokinetics of methadone in children and adolescents in the perioperative period

Introduction Previous studies by Gourlay and coworkers1-3 have demonstrated that in adults undergoing surgery, methadone has slow elimination and a very long duration of effective analgesia. For children, intramuscular injections are a major source…

A prospective evaluation of opioid weaning in opioid-dependent pediatric critical care patients

Critically ill children are treated with opioid medication in an attempt to decrease stress and alleviate pain during prolonged pediatric intensive care. This treatment plan places children at risk for opioid dependency. Once dependent, children need…

Judging the effectiveness of analgesia for children and adolescents during vaso-occlusive events of sickle cell disease

The effectiveness of analgesia during sickle cell crisis was examined in this descriptive, exploratory study. Pain scores (using the African-American Oucher and the Adolescent Pediatric Pain Tool) and analgesics administered were examined during a…

Palliative care tips: Commonly administered sub-cutaneous medications in palliative care

2002

Tags: "Hypnotics and Sedatives", 2002, Analgesics, Antiemetics, Backlog, Bielech M, Journal Article, Morphine, Narcotics, Opioid, Palliative Care, Pharmaceutical Preparations, Terminal Care, Turnbull K, Watanabe S

Association between opioid prescribing patterns and opioid overdose-related deaths

CONTEXT: The rate of prescription opioid-related overdose death increased substantially in the United States over the past decade. Patterns of opioid prescribing may be related to risk of overdose mortality. OBJECTIVE: To examine the association of…

Tissue monocytes/macrophages in inflammation: hyperalgesia versus opioid-mediated peripheral antinociception

BACKGROUND: Opioid-containing leukocytes migrate to peripheral sites of inflammation. On exposure to stress, opioid peptides are released, bind to opioid receptors on peripheral sensory neurons, and induce endogenous antinociception. In later stages…

Ketamine for pain in adults and children with cancer: a systematic review and synthesis of the literature

OBJECTIVE: Chronic cancer pain is often refractory and difficult to treat. Ketamine is a medication with evidence of efficacy in the treatment of chronic pain. DESIGN: This article presents a synthesis of the data on ketamine for refractory cancer…

Tags: 2013, Adult, Analgesics, Backlog, Bredlau AL, Child, Clinical Trials as Topic, Dworkin RH, Humans, Intractable, Journal Article, Ketamine, Korones DN, Neoplasms, Pain, Pain Management, Pain Medicine (malden, Mass.), Thakur R

Pain management: a fundamental human right

This article surveys worldwide medical, ethical, and legal trends and initiatives related to the concept of pain management as a human right. This concept recently gained momentum with the 2004 European Federation of International Association for the…

Tags: 2007, Analgesics, Anesthesia & Analgesia, Backlog, Brennan F, Carr DB, Chronic Disease, Cousins M, Drug and Narcotic Control/legislation & jurisprudence, Human Rights/legislation & jurisprudence, Humans, Journal Article, Opioid/therapeutic use, Pain/epidemiology/therapy, World Health Organization

Treatment of pediatric chronic pain with tramadol hydrochloride: siblings with Ehlers-Danlos syndrome - Hypermobility type

OBJECTIVE: To evaluate the effectiveness of tramadol hydrochloride for the treatment of chronic pain refractory to previous treatment in two pediatric patients. METHODS: Tramadol hydrochloride was administered (50 mg/day to 150 mg/day) to two…

Tags: 2004, Analgesics, Backlog, Brown SC, Child, Chronic Disease, Ehlers-Danlos Syndrome/complications, Humans, Joint Instability/etiology, Journal Article, Male, Opioid/administration & dosage, Pain Research & Management, Pain/drug therapy/etiology, Preschool, Stinson J, Tramadol/administration & dosage

Opioid rotation in patients with cancer pain. A retrospective comparison of dose ratios between methadone, hydromorphone, and morphine

BACKGROUND. When a change of opioid is considered, equianalgesic dose tables are used. These tables generally propose a dose ratio of 5:1 between morphine and hydromorphone. In the case of a change from subcutaneous hydromorphone to methadone, dose…

Methadone use in cancer patients with pain: a review

In recent years a better understanding of the pharmacologic and pharmacokinetic properties of methadone, including equianalgesic ratios has led to its increased use as a second line opioid for the treatment of pain in patients with cancer. Methadone…

Tags: 2002, Analgesics, Backlog, Bruera E, Drug Interactions, Humans, Journal Article, Journal of Palliative Medicine, Methadone/pharmacokinetics/therapeutic use, Neoplasms/complications, Opioid/pharmacokinetics/therapeutic use, Pain/drug therapy/etiology, Sweeney C

Can we use methadone for analgesia in neonates?

2001

Tags: 2001, Adult, Analgesia/methods, Analgesics, Anand KJ, Archives of Disease in Childhood. Fetal and Neonatal Edition, Backlog, Chana SK, Child, Drug Tolerance, Humans, Infant, Journal Article, Methadone, Newborn, Opioid/adverse Effects, Preschool

Opioid analgesics: comparative features and prescribing guidelines

The term 'opioid' is a generic term for naturally occurring, semisynthetic and synthetic drugs which combine with opioid receptors to produce physiological effects and which are stereospecifically antagonised by naloxone. For clinical purposes,…

Tags: 1996, Analgesics, Backlog, Cherny NI, Comparative Study, Drug, Drugs, Humans, Journal Article, Opioid/administration & dosage/adverse effects/therapeutic use, Pain/drug Therapy, Prescriptions

What we still don't know about treating chronic noncancer pain with opioids

2010

Tags: 2010, Analgesics, Backlog, Canadian Medical Association Journal, Chou R, Chronic Disease, Humans, Journal Article, Opioid/therapeutic use, Pain/drug Therapy, Practice Guidelines As Topic

A randomized, controlled trial of acetaminophen, ibuprofen, and codeine for acute pain relief in children with musculoskeletal trauma

OBJECTIVE: Our goal was to determine which of 3 analgesics, acetaminophen, ibuprofen, or codeine, given as a single dose, provides the most efficacious analgesia for children presenting to the emergency department with pain from acute musculoskeletal…

Massive opioid resistance in an infant with a localized metastasis to the midbrain periaqueductal gray

We report the case of a 4-month-old infant with terminal malignancy who had systemic metastases and a localized metastasis to the dorsal midbrain periaqueductal gray (PAG). Extraordinary doses of opioids (dose equivalent of 2680 mg morphine…

Patient-controlled analgesia for mucositis pain in children: a three-period crossover study comparing morphine and hydromorphone

OBJECTIVES: (1) To test the safety and efficacy of a clinical protocol for administering opioid by using patient-controlled analgesia (PCA) for the management of mucositis pain in children after bone marrow transplantation, (2) to compare the…

Difficult pain

Codeine phosphate in children: time for re-evaluation?

2001

Tags: 2001, Analgesics, Backlog, British Journal Of Anaesthesia, Child, Codeine/therapeutic use, Cunliffe M, Evidence-based Medicine, Human, Infant, Journal Article, Opioid/therapeutic use, Pain, Postoperative/drug therapy

Clinical experience with oral methadone administration in the treatment of pain in 196 advanced cancer patients

PURPOSE: The aims of this study were to describe the analgesia, side effects, and dosage and the causes of suspension of treatment in a large sample of advanced cancer patients with pain after treatment with oral methadone from 7 to 90 days. PATIENTS…

Opioids in renal failure and dialysis patients

This article reviews the literature pertaining to the metabolism of several of the commonly used opioids, and the known activity of their metabolites. The effect of renal failure on the pharmacokinetics of these drugs and metabolites is then…

Tags: 2004, Analgesics, Backlog, Chronic/complications/therapy, Dean M, Humans, Journal Article, Journal of Pain and Symptom Management, Kidney Failure, Opioid/therapeutic use, Pain/drug Therapy, Peritoneal Dialysis

Prescribing of opioid analgesics and related mortality before and after the introduction of long-acting oxycodone

INTRODUCTION: Opioid-related mortality appears to be increasing in Canada. We examined the true extent of the problem and the impact of the introduction of long-acting oxycodone. METHODS: We examined trends in the prescribing of opioid analgesics in…

Tags: 2009, Analgesics, Backlog, Canadian Medical Association Journal, Delivery of Health Care/utilization, Dhalla IA, Humans, Journal Article, Juurlink DN, Kopp A, Mamdani M, Mortality/trends, Ontario/epidemiology, Opioid/poisoning/therapeutic use, Oxycodone/therapeutic use, Poisoning/mortality/prevention & control, Prescription Drugs/poisoning/therapeutic use, Qureshi O, Sivilotti ML

Direct conversion from oral morphine to transdermal fentanyl: a multicenter study in patients with cancer pain

Direct conversion from oral morphine to transdermal fentanyl with a ratio of oral morphine/transdermal fentanyl (100:1 mg) daily was examined in patients with cancer pain. Patients with a 'stable and low level of cancer pain' receiving a constant…

Tags: 1996, Administration, Adult, Aged, Analgesics, Backlog, Cutaneous, Donner B, Female, Fentanyl, Humans, Journal Article, Male, Middle Aged, Morphine, Neoplasms, Opioid, Pain, Pain Measurement, Regression Analysis, Strumpf M, Tryba M, Zenz M

A prospective study of adverse reactions to the weaning of opioids and benzodiazepines among critically ill children

2005

Tags: 13-20% for 4-7 days, 2005, 8-13% for 8-14 days, 8% for 15-21 days, Adolescent Age Factors, Analgesics, and 2-4% for more t han 21 days of infusions. The authors recommend that the rate of weaning of opioids and benzodiazepines in critically ill children be tailored to the length of time the child received continuous infusions of these agents., Backlog, Benzodiazepines/administration & dosage/adverse effects Child Child, Carnevale FA, Clermont MS, Ducharme C, Health Care Statistics, Intensive and Critical Care Nursing, Intravenous Intensive Care Units, Journal Article, Methods, methods/standards Critical Illness/therapy Drug Administration Schedule Drug Monitoring/, Newborn Infusions, Nonparametric, Nursing, Opioid/administration & dosage/adverse effects, Pediatric Nursing Assessment Nursing Evaluation Research Pediatric Nursing, PedPal Lit, Preschool Conscious Sedation/adverse effects/methods/nursing Critical Care/, Shea S, standards Humans Infant Infant, standards Prospective Studies Quality Assurance, Substance Withdrawal Syndrome/diagnosis/etiology/prevention & control Time Factors

Use of a clinical pathway to improve the acute management of vaso-occlusive crisis pain in pediatric sickle cell disease

BACKGROUND: The most common, debilitating morbidity of sickle cell disease (SCD) is vaso-occlusive crisis (VOC) pain. Although guidelines exist for its management, they are generally not well-followed, and research in other pediatric diseases has…

A randomized, controlled trial of intravenous clodronate in patients with metastatic bone disease and pain

To evaluate the effectiveness of intravenous clodronate in ameliorating refractory bone pain in patients with metastatic bone disease, 60 patients with established osseous metastases and persistent bone pain were randomized to receive either…

Efficacy and complications of morphine infusions in postoperative paediatric patients

The aim of the study was to evaluate the efficacy and the incidence of clinically significant adverse drug reactions (ADRs) in paediatric patients receiving continuous intravenous morphine infusions for acute postoperative pain. Definitions were…

Patient-controlled analgesia

In appropriately selected patients, PCA safely provides analgesia superior to that obtained with traditional IM prn opioid administration; however, to date, no compelling evidence shows that PCA is associated with a reduction in morbidity or a more…

A multicentre international study of sedation for uncontrolled symptoms in terminally ill patients

The issue of symptom management at the end of life and the need to use sedation has become a controversial topic. This debate has been intensified by the suggestion that sedation may correlate with 'slow euthanasia'. The need to have more facts and…

Should we be reluctant to prescribe opioids for chronic non-malignant pain?

2007

Tags: 2007, Analgesics, Attitude Of Health Personnel, Backlog, Chronic Disease, Fields HL, Humans, Journal Article, Neoplasms/complications, Opioid-Related Disorders/etiology/prevention & control, Opioid/adverse effects/therapeutic use, Pain, Pain/drug therapy/etiology, Physician's Practice Patterns/trends

Transdermal fentanyl in the management of children with chronic severe pain: results from an international study

BACKGROUND: The current study was conducted to assess the safety and tolerability of a transdermal fentanyl delivery system for the relief of chronic pain in a pediatric population, and also to validate titration recommendations and conversion to…

Deaths related to the use of prescription opioids

2009

Tags: 2009, Analgesics, Backlog, Canadian Medical Association Journal, Fischer B, Humans, Journal Article, Mortality, Ontario/epidemiology, Opioid/poisoning, Prescription Drugs/poisoning, Rehm J

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