Browse Items · Pediatric Palliative Care Library

Ketamine-fentanyl-midazolam infusion for the control of symptoms in terminal life care

In this report, we describe nine terminally ill patients with metastatic cancer who were treated with an intravenous infusion consisting of ketamine (2 mg/ml)/fentanyl (5 micrograms/ml)/midazolam (0.1 mg/ml) (K/F/M) to control pain after traditional…

Plasma morphine levels produced by continuous infusion in children

Blood samples were taken from six children aged between 10 months and 15 years, at intervals over a period of 40 hours while they were receiving continuous morphine infusions. The plasma morphine values obtained showed similar and consistent levels…

Tags: 1986, Adolescent, Anaesthesia, Backlog, Beeton C, Bray RJ, Child, Hinton W, Humans, Infant, Infusions, Journal Article, Morphine/administration & dosage/blood/therapeutic use, Pain, Parenteral, Postoperative/drug therapy, Preschool, Seviour JA, Time Factors

Control of severe pain in children with terminal malignancy

OBJECTIVE: To identify the characteristics of the subset of children with malignancy in whom massive opioid infusions are needed during the terminal phase. DESIGN: Retrospective review of the records of the 199 patients who died of malignancy after…

Patient-controlled analgesia with low dose background infusions after lower abdominal surgery in children

Forty-five children (aged 6-12 yr) undergoing appendicectomy received one of three analgesic regimens using patient-controlled analgesia (PCA) with morphine: no background infusion (BO); background infusion 4 micrograms kg-1 h-1 (B4); background…

A double-blind, crossover trial of intravenous clodronate in metastatic bone pain

After a baseline symptom and laboratory assessment, 24 patients with metastatic bone disease and pain were randomized to receive either a 4-hr intravenous infusion of 2-dichloromethylene bisphosphonate (Cl2MDP), 600 mg in 500 mL of normal saline, or…

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…

The decision to use topical anesthetic for intravenous insertion in the pediatric emergency department

OBJECTIVES: Topical anesthetic creams to reduce the pain of intravenous (IV) placement may be more effectively used in the emergency setting if they are applied by nurses in the triage area of the emergency department or soon after the patient is…

Using high-dose morphine to relieve cancer pain

For cancer patients, the question of how much morphine is too much may be irrelevant-they need as much as it takes to relieve their pain. Discover the principles of administering high doses of morphine, including which routes to use, how to convert…

Tags: 1993, Adult, Backlog, Fulton JS, Humans, Infusions, Intravenous, Johnson GB, Journal Article, Male, Morphine/administration & dosage/adverse effects, Neoplasms/physiopathology, Nursing, Oncologic Nursing/methods, Pain/drug therapy/nursing

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…

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…

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…

Short-term safety assessment in the use of intravenous zoledronic acid in children

The clinical side effects of the potent new bisphosphonate zoledronic acid in children are unknown. In this study of 34 children with various bone disorders, the frequency of postinfusion flu-like illness, hypocalcemia, and hypophosphatemia was 85%,…

Pharmacokinetics of continuous infusions of fentanyl in critically ill children

OBJECTIVE: To determine the pharmacokinetics of fentanyl when used as a long-term continuous infusion for sedation/analgesia in mechanically ventilated critically ill infants and children. DESIGN: Prospective, case series. SETTING: A university…

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…

Long-term use of peripherally inserted central venous catheters for cancer chemotherapy in children

BACKGROUND: Peripherally inserted central venous catheters (PICCs) have been increasingly used in pediatric patients. However, little is known about the incidence and risk of complications when using this device in children with cancer. The purposes…

Effective parenteral clodronate treatment of a child with severe juvenile idiopathic osteoporosis

We report on an 8 years and 3 months old boy with severe idiopathic juvenile osteoporosis (IJO). Clinical features included multiple fractures, especially of the vertebrae, and neurological symptoms. Biological studies showed non-parathyroid…

Continuous subcutaneous infusion of morphine in children with cancer

Seventeen children with severe pain due to malignant neoplasm were successfully treated with a subcutaneous infusion of morphine sulfate using a syringe pump. Pain relief was adequate in every case without major side effects. The median dosage…

Continuous intravenous infusion of morphine sulfate for control of severe pain in children with terminal malignancy

1980

Tags: 1980, Backlog, Child, Clark BS, Infusions, Injections, Intractable, Intravenous, Journal Article, Journal of Pediatrics, Miser AW, Miser JS, Morphine, Pain, Palliative Care, Palliative Treatment, Parenteral, Terminal Care

Comparison of continuous subcutaneous and intravenous hydromorphone infusions for management of cancer pain

To compare the safety and efficacy of subcutaneous and intravenous infusion of opioid analgesics, a randomised, double-blind, crossover trial was carried out in inpatients. 15 patients with severe cancer pain received two 48 h infusions of…

Patient-controlled analgesia with intravenous L-methadone in a child with cancer pain refractory to high-dose morphine

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.…

Pharmacokinetic optimisation of opioid treatment in acute pain therapy

Traditionally, opioids have been administered as fixed doses at fixed dose intervals. This approach has been largely ineffective. Patient-controlled analgesia (PCA) and upgraded traditional approaches incorporating flexibility in dose size and dose…

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

Use of patient-controlled analgesia for management of acute pain

Patient-controlled analgesia (PCA) provides improved titration of analgesic drugs, thereby minimizing individual pharmacokinetic and pharmacodynamic differences. Patient-controlled analgesia decreases patient anxiety resulting from delays in…

Tags: 1988, Acute Disease, Analgesics/administration & dosage/adverse effects, Backlog, Humans, Infusion Pumps, Infusions, Injections, Intravenous, JAMA, Journal Article, Pain/drug Therapy, Self Administration/adverse effects/instrumentation, White PF

Osteoporosis pseudoglioma syndrome: treatment of spinal osteoporosis with intravenous bisphosphonates

OBJECTIVES: To determine whether intravenous bisphosphonate treatment is helpful for children with osteoporosis pseudoglioma syndrome who have severe osteoporosis. METHODS: Three children (ages 9 to 11 years) with osteoporosis pseudoglioma syndrome…

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