Browse Items · Pediatric Palliative Care Library

High-dose oral morphine in cancer pain management: a report of twelve cases

We present 12 case reports from patients treated with more than 600 mg of morphine per day. We found no "opioid-nonresponsive pain" under treatment with a combination of morphine and nonopioids, supplemented with coanalgesics where appropriate. Side…

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

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…

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

Initial experiences with medicinal extracts of cannabis for chronic pain: results from 34 'N of 1' studies

Three Cannabis Based Medicinal Extracts (CBMEs) for sublingual use became available in 2000. A total of 34 'N of 1' studies were undertaken using this novel therapy for patients with chronic, mainly neuropathic, pain and associated symptoms to…

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…

Intravenous fentanyl for cancer pain: a "fast titration" protocol for the emergency room

Patients with cancer sometimes are admitted to the emergency room due to severe pain. Despite the fact that morphine's hydrophilicity can delay its peak effects after intravenous administration up to 30 minutes, it is still the most commonly used…

Intravenous ketamine infusion as an adjuvant to morphine in a 2-year-old with severe cancer pain from metastatic neuroblastoma

A 2.8-year-old female patient (11.6 kg) was admitted to the hospital for uncontrolled pain and swelling in the left leg relating to a metastatic neuroblastoma. Initially, her pain was managed with oral morphine 2 mg (approx. 0.2 mg/kg) every 4 hours.…

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…

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…

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

Management of burn pain in children

In spite of the many possible methods of pain control in the burned child satisfactory pain management may still be a problem, at times formidable. The most fruitful approach would seem to be frequent assessment of pain in the individual patient with…

Tags: 1989, Analgesics, Analgesics/administration & dosage/therapeutic use, Backlog, Bandages/adverse effects, Burns/complications/physiopathology, Child, Humans, Journal Article, Opioid/administration & dosage/pharmacokinetics/pharmacology/therapeutic use, Osgood PF, Pain/physiopathology/therapy, Patient Compliance, Pediatric Clinics of North America, Szyfelbein SK

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…

Methadone as treatment for iatrogenic narcotic dependency in pediatric intensive care unit patients

Methadone is safe for treating hospitalized patients with severe pain

PURPOSE: Methadone is still regarded as a second line opioid for patients suffering from severe pain, and is rarely used in hospitalized patients. The infrequent use of methadone is probably due to its long plasma half-life that could lead to…

Methadone response in advanced cancer patients with pain followed at home

Concerns about the safety of therapy with methadone, which may arise because of its pharmacokinetic characteristics and inappropriate dosing, may deter clinicians from using this drug, especially in elderly patients. Experience is accumulating that…

Methadone titration in opioid-resistant cancer pain

AIM: To assess the use of methadone in patients with cancer pain who fail to respond to increasing doses of other opioids or experience intolerable side-effects from them. METHOD: Inpatients of a specialist palliative care unit were titrated onto…

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

Modulation of peripheral endogenous opioid analgesia by central afferent blockade

BACKGROUND: Peripheral tissue injury causes a migration of opioid peptide-containing immune cells to the inflamed site. The subsequent release and action of these peptides on opioid receptors localized on peripheral sensory nerve terminals causes…

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…

Morphine is not the only analgesic in palliative care: Literature review

BACKGROUND: No comprehensive review has been published to date, which provides information for nurses on pharmaceutical alternatives to morphine in palliative care. As nurses are often the health professional most involved with terminally ill…

Tags: 2004, Analgesics, Analgesics/therapeutic use, Backlog, Fentanyl/therapeutic use, Humans, Journal Article, Journal Of Advanced Nursing, Ketamine/therapeutic use, Methadone/therapeutic use, Morphine/therapeutic Use, Neoplasms/complications, Opioid/therapeutic use, Pain/drug Therapy, Palliative Care/methods, Wootton M

Neuropathic cancer pain: prevalence, severity, analgesics and impact from the European Palliative Care Research Collaborative-Computerised Symptom Assessment study

BACKGROUND: Neuropathic pain causes greater pain intensity and worse quality of life than nociceptive pain. There are no published data that confirm this in the cancer population. AIM: We hypothesised that patients with neuropathic cancer pain had…

New and lingering controversies in pediatric end-of-life care

OBJECTIVES: Professional societies, ethics institutes, and the courts have recommended principles to guide the care of children with life-threatening conditions; however, little is known about the degree to which pediatric care providers are aware of…

Nociceptin levels in the cerebrospinal fluid of chronic pain patients with or without intrathecal administration of morphine

The neuropeptide nociceptin/orphanin FQ (N/OFQ) is the endogenous ligand for the opioid-like receptor ORL-1 and is thought to be involved in pain transmission and modulation. Human studies have not yet defined its role in pain patients. The aims of…

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…

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

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

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…

Opioid switch to oral methadone in cancer pain

The occurrence of undesirable side effects due to opioids (delirium, confusion, myoclonus, nausea, emesis) is one of the major complications in the management of pain, especially in chronic cancer pain states. Methadone, as an alternative to…

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…

Opioids

Opioids are the most effective and widely used drugs in the treatment of severe pain. They act through G protein-coupled receptors. Four families of endogenous ligands (opioid peptides) are known. The standard exogenous opioid analgesic is morphine.…

Tags: 2007, Amino Acid Sequence, Analgesics, Animals, Backlog, Biomarkers of Pain, Chronic Disease, Drug Tolerance, Handbook Of Experimental Pharmacology, Humans, Journal Article, Ligands, Molecular Sequence Data, Opioid/adverse effects/pharmacology/therapeutic use, Opioid/drug effects, Receptors, Stein C, Zollner C

Opioids and the neuroimmune axis

2005

Tags: 2005, Analgesics, Animals, Backlog, British Journal Of Anaesthesia, Humans, Immune System/drug effects/physiology, Inflammation/immunology, Journal Article, Lambert DG, mu/metabolism, Neuroimmunomodulation/immunology, Opioid, Opioid Peptides/physiology, Opioid/pharmacology, Rats, Receptors, Williams JP

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

Browse Items (131 total)