Pain medication during terminal care of children with cancer

Title

Pain medication during terminal care of children with cancer

Creator

Sirkia K; Hovi L; Pouttu J; Saarinen-Pihkala U

Publisher

Journal Of Pain And Symptom Management

Date

1998

Subject

Palliative Care; Terminal Care; Analgesics; Pain; Morphine; Analgesia; Narcotics; Palliative treatment; Children; Administration; Oral; Neoplasms; Opioid

Description

The purpose of this study was to evaluate the need for pain medication and the adequacy or inadequacy of the analgesia achieved, in children with cancer who died while in terminal care. Of the 100 pediatric patients with cancer treated at the Children's Hospital, University of Helsinki, Finland, who died during 1987-1992, 70 died while in terminal care. The underlying diseases were leukemia (N=25), solid tumors (N=24), and brain tumors (N=21). Of these children, 60% were treated at home, 29% at hospital, and 11% at both. The assessment of pain during terminal care was retrospective and included analysis of the patients' records and a structured interview of the two parents separately. In total, 62 children (89%) received regular pain medication, with a mean duration of 17 days in children with leukemia, 58 days in those with solid tumors, and 66 days in those with brain tumors. Medication was usually started with anti-inflammatory drugs, then changed to oral opioids when deemed necessary, and finally to parenteral opioids. Parenteral morphine was administered to 40 children, to 30 as a continuous infusion through a central venous line. The dose of morphine was 0.8 mg/kg/day at the start and was increased to 4.9 (range, 0.2-55) mg/kg/day. Of the 62 children who received regular pain medication, the majority (81%) had adequate analgesia. In 19%, analgesia had been suboptimal. In conclusion, the vast majority of children with cancer need regular pain medication while in terminal care. This can be administered adequately at home, even if continuous intravenous infusions are required.
1998

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

220-6

Issue

4

Volume

15

Citation

Sirkia K; Hovi L; Pouttu J; Saarinen-Pihkala U, “Pain medication during terminal care of children with cancer,” Pediatric Palliative Care Library, accessed December 4, 2021, https://pedpalascnetlibrary.omeka.net/items/show/12198.

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