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Safety and efficacy of fentanyl administered by patient controlled analgesia in children with cancer pain

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Abstract

Background

Pain is the most common discomfort experienced by children with cancer and occurs in almost 89% of patients in an advanced stage of the disease. It is most often not adequately treated because of inexperience and unfounded fears of analgesic treatment. In adults, patient controlled analgesia (PCA) is widely administered, while in children with moderate to severe cancer pain its use is still under evaluation for safety and efficacy.

Goals of work

To evaluate the efficacy and safety of fentanyl administered by PCA in children with cancer pain.

Materials and methods

Eighteen children (range 6 to 15 years) with moderate to severe pain were enrolled and treated with fentanyl by PCA plus background infusion (BI) (BI of 1 μg/kg/h with booster doses of 1 μg/kg by intravenous route). To evaluate efficacy and safety of the analgesic treatment, different subjective and objective parameters were monitored at 4-h intervals. In addition, patients’ satisfaction was assessed by a questionnaire at the end of the treatment.

Main results

All children experienced a good degree of analgesia and did not require any other analgesic drug during the treatment. Both subjective and objective parameters improved after starting pain-relieving treatment and no major side effects occurred. The questionnaire administered to the children showed a high grade of satisfaction.

Conclusions

PCA plus BI with fentanyl administered by intravenous route is a safe and efficacious method for analgesia in children with moderate to severe cancer pain. Our policy of fentanyl-treatment did not show any major side effects.

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References

  1. Berde CB, Lehn BM, Yee JD, Sethna NF, Russo D (1991) Patient-controlled analgesia in children and adolescents: a randomized, prospective comparison with intramuscular administration of morphine for postoperative analgesia. J Pediatr 118:460–466

    Article  PubMed  CAS  Google Scholar 

  2. Bray RJ, Woodhams AM, Vallis CJ, Kelly PJ, Ward-Platt MP (1996) A double-blind comparison of morphine infusion and patient controlled analgesia in children. Paediatr Anaesth 6:121–127

    Article  PubMed  CAS  Google Scholar 

  3. Coda BA, O’Sullivan S, Donaldson G, Bohl S, Chapman CR, Shen DD (1997) Comparative efficacy of patient-controlled administration of morphine, hydromorphone, or sufentanil for the treatment of oral mucositis pain following bone marrow transplantation. Pain 72:333–346

    Article  PubMed  CAS  Google Scholar 

  4. Dunbar PJ, Buckley P, Gavrin JR, Sanders JE, Chapman CR (1995) Use of patient-controlled analgesia for pain control for children receiving bone marrow transplant. J Pain Symptom Manage 10:604–611

    Article  PubMed  CAS  Google Scholar 

  5. Gaukroger PB, Chapman MJ, Davey RB (1991) Pain control in paediatric burns—the use of patient controlled analgesia. Burns 17:396–399

    Article  PubMed  CAS  Google Scholar 

  6. Lehmann KA (2005) Recent developments in patient-controlled analgesia. J Pain Symptom Manage 29:S72–S89

    Article  PubMed  Google Scholar 

  7. Mackie AM, Coda BC, Hill HF (1991) Adolescents use patient-controlled analgesia effectively for relief from prolonged oropharyngeal mucositis pain. Pain 46:265–269

    Article  PubMed  CAS  Google Scholar 

  8. Owen H, Mather LE, Runciman WB, Carapetis RJ, Upton RN (1987) The lockout interval in patient-controlled analgesia: a rational basis for choice? Br J Anaesth 59:1328–1329

    Google Scholar 

  9. Owen H, Plummer JL, Armstrong I, Mather LE, Cousins MJ (1989) Variables of patient controlled analgesia. 1. Bolus size. Anaesthesia 44:7–10

    Article  PubMed  CAS  Google Scholar 

  10. Peters JW, Bandel Hoekstra IE, Huijer Abu-Saad H, Bouwmeester J, Meursing AE, Tibboel D (1999) Patient controlled analgesia in children and adolescents: a randomized controlled trial. Paediatr Anaesth 9:235–241

    Article  PubMed  CAS  Google Scholar 

  11. Plummer JL, Owen H, Ilsley AH, Inglis S (1997) Morphine patient controlled analgesia is superior to meperidine patient-controlled analgesia for postoperative pain. Anesth Analg 84:794–799

    Article  PubMed  CAS  Google Scholar 

  12. Rodgers BM, Webb CJ, Stergios D, Newman BM (1988) Patient-controlled analgesia in pediatric surgery. J Pediatr Surg 23:259–262

    Article  PubMed  CAS  Google Scholar 

  13. Shapiro BS, Cohen DE, Howe CJ (1993) Patient-controlled analgesia for sickle-cell-related pain. J Pain Symptom Manage 8:22–28

    Article  PubMed  CAS  Google Scholar 

  14. Sidebotham D, Dijkhuizen MR, Schug SA (1997) The safety and utilization of patient-controlled analgesia. J Pain Symptom Manage 14:202–209

    Article  PubMed  CAS  Google Scholar 

  15. Sirkia K, Hovi L, Pouttu J, Saarinen-Pihkala UM (1998) Pain medication during terminal care of children with cancer. J Pain Symptom Manage 15:220–226

    Article  PubMed  CAS  Google Scholar 

  16. Tobias JD, Baker DK (1991) Patient controlled analgesia with fentanyl in children. Clin Pediatr 31:177–179

    Google Scholar 

  17. Trentadue NO, Kachoyeanos MK, Lea G (1998) A comparison of two regimens of patient-controlled analgesia for children with sickle cell disease. J Pediatr Nurs 13:15–19

    Article  PubMed  CAS  Google Scholar 

  18. Tyler DC, Pomietto M, Womack W (1996) Variation in opioid use during PCA in adolescents. Paediatr Anaesth 6:33–38

    Article  PubMed  CAS  Google Scholar 

  19. Walco GA, Cassidy RC, Schechter NL (1994) Pain, hurt, and harm. The ethics of pain control in infants and children. N Engl J Med 331:541–544

    Article  PubMed  CAS  Google Scholar 

  20. Wong DL, Baker CM (1988) Pain and children: comparison of assessment scales. Pediatr Nurs 14:9–17

    PubMed  CAS  Google Scholar 

  21. Yeh CH, Lin CF, Tsai JL, Lai YM, Ku HC (1999) Determinants of parental decisions on ‘drop out’ from cancer treatment for childhood cancer patients. J Adv Nurs 30:193–199

    Article  PubMed  CAS  Google Scholar 

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Correspondence to A. Ruggiero.

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Ruggiero, A., Barone, G., Liotti, L. et al. Safety and efficacy of fentanyl administered by patient controlled analgesia in children with cancer pain. Support Care Cancer 15, 569–573 (2007). https://doi.org/10.1007/s00520-006-0193-8

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  • DOI: https://doi.org/10.1007/s00520-006-0193-8

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