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

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

Shir Y; Shenkman Z; Shavelson V; Davidson EM; Rosen G

Clinical Journal Of Pain

1998

Child; Female; Male; Analgesics; Parents; Treatment Outcome; Analgesia; Preschool; Administration; Oral; Neoplasms/therapy; Human; Case Report; Opioid/therapeutic use; Patient-Controlled; Wounds; Hospitalization; Palliative Care/methods; Burns/therapy; Methadone/therapeutic use; Nonpenetrating/therapy; Osteopetrosis/therapy; Pain/physiopathology

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 children with persistent pain from cancer, burns, or trauma who were capable of oral intake and whose pain was not relieved by nonopioid medications. SETTING: Tertiary university hospital. PATIENTS: Of the 70 children treated thus far with oral methadone, five are described in the present report. MAIN OUTCOME MEASURE: Pain relief, acceptability, and side effects of oral methadone in children with pain. RESULTS: Treatment with oral methadone (0.1% in 10% glucose, dose range of 0.2-0.6 mg/kg/day) for time periods of up to 6 weeks resulted in a rapid onset and stable pain relief, with no major side effects. No adverse responses were encountered after discontinuation of treatment. In three of the children, a parent-controlled analgesia regimen was successfully employed. CONCLUSIONS: Oral methadone can be recommended for babies and children who have severe pain that is not alleviated by nonopioid medications and who are capable of oral intake.

1998

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