Browse Items · Pediatric Palliative Care Library

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…

A systematic review of opioid conversion ratios used with methadone for the treatment of pain

OBJECTIVE: Review and analyze the evidence base comprising methadone conversion methods and associated dosing ratios for the treatment of pain. DESIGN: Systematic review. METHODS: Clinical trials and retrospective analyses, case series, and case…

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

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…

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…

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…

Difficult pain

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

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…

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

Disappearance of morphine-induced hyperalgesia after discontinuing or substituting morphine with other opioid agonists

Hyperalgesia and allodynia in 4 cancer patients treated with morphine disappeared after discontinuing or substituting morphine with other opioid agonists. The first case describes a young female who developed hyperalgesia and myoclonus during…

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…

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…

Pain control by immune-derived opioids

1. The nervous and immune systems communicate with each other by use of cytokines and neuropeptides. 2. Interactions between immune cell-derived opioid peptides and opioid receptors located in peripheral inflamed tissue lead to endogenous analgesia.…

Tags: 2000, Analgesics, Backlog, Biomarkers of Pain, Clinical And Experimental Pharmacology & Physiology, Humans, Journal Article, Machelska H, Neuropeptides/therapeutic use, Opioid/drug effects/immunology, Opioid/therapeutic use, Pain/drug therapy/immunology, Peripheral Nervous System/drug effects, Receptors, Stein C

Oral methadone for the treatment of severe pain in hospitalized children: a report of five cases

OBJECTIVE: Pain relief is still inadequate in many hospitalized patients, especially children in whom suboptimal use of analgesic drugs is still common. In the past 2 years, oral methadone has been used extensively in our institution for treating…

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…

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…

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