Browse Items · Pediatric Palliative Care Library

Safe lumbar puncture under analgo-sedation in children with acute lymphoblastic leukemia

BACKGROUND: Children with acute lymphoblastic leukemia (ALL) undergo multiple lumbar punctures (LPs) during their course of treatment for diagnostic and therapeutic purposes. LP is a stressful and painful procedure, affecting the quality of life of…

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…

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…

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…

Cost-effectiveness analysis of ziprasidone versus haloperidol in sequential intramuscular/oral treatment of exacerbation of schizophrenia: economic subanalysis of the ZIMO trial.

OBJECTIVE: This study aimed to assess the cost effectiveness of ziprasidone versus haloperidol in sequential intramuscular (IM)/oral treatment of patients with exacerbation of schizophrenia in Spain. METHODS: A cost-effectiveness analysis from the…

Menkes' kinky hair syndrome

Neurologically impaired children and digestive problems

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…

Bisphosphonate treatment of bone disease

In 1997 a review article on bisphosphonates in this journal identified 24 published articles relating to children at that time. Since then there has been a considerable increase in their use in clinical paediatric practice and research with there…

Different mechanisms of intrinsic pain inhibition in early and late inflammation

Neuroimmune interactions control pain through activation of opioid receptors on sensory nerves by immune-derived opioid peptides. Here we evaluate mechanisms of intrinsic pain inhibition at different stages of Freund's adjuvant-induced inflammation…

The use of subcutaneous pamidronate

2003

Tags: 2003, Anti-Inflammatory Agents/administration & dosage, Backlog, Clodronate, Diphosphonates/administration & dosage, Duncan AR, Humans, Hypercalcemia/drug therapy, Injections, Journal Article, Journal of Pain and Symptom Management, Subcutaneous

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…

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…

Clinical pharmacokinetics of morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use…

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…

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…

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…

Prolotherapy injections, saline injections, and exercises for chronic low-back pain: a randomized trial

Objectives: To assess the efficacy of a prolotherapy injection and exercise protocol in the treatment of chronic nonspecific low back pain. Design: Randomized controlled trial with two-by-two factorial design, triple-blinded for injection status, and…

Tags: 2004, Backlog, Bogduk N, Exercise, Glasziou PP, Injections, Journal Article, Low back pain, McKernon M, Randomized Controlled Trials, Schluter PJ, Sclerotherapy, Spine, Yelland MJ

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

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

Self-administration of intravenous analgesics

1970

Tags: 1970, Analgesics/administration & dosage, Anesthesiology, Backlog, Equipment and Supplies, Forrest WH, Hospital, Injections, Intravenous/instrumentation, Journal Article, Kienitz ME, Self Medication/instrumentation, Smethurst PW

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…

A Phase I, open label, dose ranging trial of intravenous bolus zoledronic acid, a novel bisphosphonate, in cancer patients with metastatic bone disease

BACKGROUND: Bone metastases typically are associated with osteolytic bone destruction, resulting in bone pain, pathologic fractures, spinal cord compression, and hypercalcemia. Bisphosphonates are potent inhibitors of normal and pathologic bone…

Local analgesic effect of endogenous opioid peptides

Opioids produce analgesia by interacting with local opioid receptors in peripheral inflamed tissue. This study investigated whether endogenous ligands of these receptors are present in synovia and whether such opioid peptides can inhibit pain by…

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 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…

Subcutaneous clodronate: a study evaluating efficacy in hypercalcemia of malignancy and local toxicity

The logistics of administering intravenous bisphosphonates may be problematic in the care of advanced cancer patients, especially in the home setting. Hypodermoclysis is a convenient method of administering fluid via subcutaneous infusion, presently…

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…

Neostigmine increases postoperative colonic motility in patients undergoing colorectal surgery

BACKGROUND: Gastrointestinal motility is frequently impaired after abdominal surgery. We investigated the effects of neostigmine on colonic motility in patients after colorectal surgery and in healthy volunteers. METHODS: Colonic motility was…

Interleukin 1 beta and corticotropin-releasing factor inhibit pain by releasing opioids from immune cells in inflamed tissue

Local analgesic effects of exogenous opioid agonists are particularly prominent in painful inflammatory conditions and are mediated by opioid receptors on peripheral sensory nerves. The endogenous ligands of these receptors, opioid peptides, have…

Tags: 1994, Analysis of Variance, Animals, Antibodies/pharmacology, Backlog, beta-Endorphin/immunology/physiology, Biomarkers of Pain, Carter L, Corticotropin-Releasing Hormone/administration & dosage/pharmacology/therapeutic use, Cyclosporine/pharmacology, Dose-Response Relationship, Drug, Dynorphins/immunology/physiology, Endorphins/immunology/physiology/secretion, Enkephalin, Humans, Inflammation/immunology/physiopathology, Injections, Interleukin-1/administration & dosage/pharmacology/therapeutic use, Journal Article, Leucine/analogs & derivatives/pharmacology, Male, Methionine/immunology/physiology, Naloxone/pharmacology, Pain/immunology/physiopathology/prevention & control, Proceedings Of The National Academy Of Sciences Of The United States Of America, Rats, Recombinant Proteins/pharmacology/therapeutic use, Regression Analysis, Schafer M, Somatostatin/analogs & derivatives/pharmacology, Stein C, Wistar

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…

Browse Items (31 total)