Browse Items · Pediatric Palliative Care Library

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

View through a window may influence recovery from surgery

Records on recovery after cholecystectomy of patients in a suburban Pennsylvania hospital between 1972 and 1981 were examined to determine whether assignment to a room with a window view of a natural setting might have restorative influences.…

Use of opioids in the treatment of severe pain in terminally ill patients--dying should not be painful

Pain is a common symptom at the end of life. The vast majority of pain can be readily managed if simple principles of practice are followed. Chronic pain requires continuous analgesia, and severe pain requires use of strong analgesics, most commonly…

Use of methadone in the morphine-tolerant burned paediatric patient

We describe the successful use of methadone in the restoration of sedation and provision of analgesia in two morphine-tolerant, paediatric patients who had suffered significant thermal injuries and were undergoing mechanical ventilation. Both…

Use of intravenous acetaminophen (paracetamol) in a pediatric patient at the end of life: case report

BACKGROUND: For the better part of 100 years, acetaminophen (or paracetamol as it is known outside of the United States) has been a common first-line analgesic in pediatrics and is typically well tolerated with minimal side effects. Its use as an…

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…

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…

Trends in the use of opioids at the end of life and the expected effects on hastening death

The aim of our study was to describe trends in opioid use and perceptions of having hastened the end of life of a patient. In 2005, a questionnaire was sent to 6860 physicians in The Netherlands who had attended a death. The response rate was 78%. In…

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

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

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…

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…

Tramadol: does it have a role in cancer pain management?

Tramadol (Ultram, Ortho-McNeil Pharmaceutical, Inc., Raritan, NJ) is considered a Step 2 analgesic under the World Health Organization's guidelines for the treatment of patients with cancer pain. It is a centrally acting analgesic that has affinity…

Tags: 2005, Analgesics, Backlog, Humans, Journal Article, Journal of opioid management, Methadone, Neoplasms/complications, Opioid/adverse effects/chemistry/pharmacokinetics/therapeutic use, Pain/drug therapy/etiology, Prommer EE, Tramadol/adverse effects/chemistry/pharmacokinetics/therapeutic use

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…

The use of methadone for cancer pain

Methadone is not a new analgesic drug [69]. Several studies have demonstrated that methadone is a valid alternative to morphine, hydromorphone, and fentanyl for the treatment of cancer-related pain, and extensive reviews on the subject have been…

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…

The opiate hypothesis in autism and self-injury

The opiate hypothesis maintains that patients engage in self-injurious behavior (SIB) either because they are partially analgesic (pathologically altered pain threshold) or because SIB supplies a "fix" for an addicted endogenous opiate system. The…

Tags: 1990, Analgesics, Autism, Autistic disorder, Backlog, Journal Article, Journal Of Child And Adolescent Psychopharmacology, Naloxone, Naltrexone, Opioid, Pain, Pain Measurement, Pain Threshold, Sandman CA, Self Mutiliation, Self-Injurious behavior

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…

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…

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

The challenge of preemptive analgesia

2005

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

Switching from morphine to oral methadone in treating cancer pain: what is the equianalgesic dose ratio?

PURPOSE: To define the dose ratio between morphine and methadone in relation to the previous morphine dose and the number of days needed to achieve the same level of analgesia in a group of patients with advanced cancer with pain who switched from…

Switching from morphine to methadone to improve analgesia and tolerability in cancer patients: a prospective study

PURPOSE: To evaluate the clinical benefits of switching from morphine to oral methadone in patients who experience poor analgesia or adverse effects from morphine. PATIENTS AND METHODS: Fifty-two consecutive cancer patients receiving oral morphine…

Sublingual absorption of selected opioid analgesics

Ongoing interest in the improvement of pain management with opioid analgesics had led to the investigation of sublingual opioid absorption. The present report determined the percent absorption of selected opioid analgesics from the oral cavity of…

Subcutaneous clodronate

1996

Tags: 1996, Aged, Analgesics, Backlog, Bruera E, Clodronic Acid/administration & dosage, Humans, Hypercalcemia/drug therapy, Infusions, Journal Article, Lancet, Lawlor P, Male, Middle Aged, Non-Narcotic/administration & dosage, Parenteral, Walker P, Watanabe S

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

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

Safety of subcutaneous clodronate and efficacy in hypercalcemia of malignancy: a novel route of administration

Bisphosphonates have become standard treatment in management of malignancy-induced hypercalcemia and malignant bone pain. One obstacle to the routine use of bisphosphonates in palliative patients is that oral bisphosphonates have low bioavailability…

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…

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

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…

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

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…

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…

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