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Clinical aspects and treatment of pain in children and adolescents with cancer
Author(s) -
Monteiro Caran Eliana Maria,
Dias Carla Gonçalves,
Seber Adriana,
Petrilli Antonio Sérgio
Publication year - 2005
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.20523
Subject(s) - medicine , palliative care , cancer pain , morphine , cancer , opioid , breakthrough pain , prospective cohort study , socioeconomic status , physical therapy , anesthesia , population , receptor , nursing , environmental health
Background The aim of this study was to characterize the clinical aspects and the treatment of mild to severe pain in Brazilian children and adolescents with cancer. We evaluated the importance of classifying patients according to the phase of cancer treatment (diagnosis, treatment, recurrence, and end‐of‐life palliative care) and the opioid‐related side effects. Methods An institutional prospective study of 184 episodes of pain in children and adolescents with cancer was conducted. Pain was classified according to its cause, physiopathology and intensity. Treatment was based on the WHO guidelines for cancer pain relief. Results Pain scales were completed by 77% of the patients. Numerical scales were used by 49% of them. Morphine was given in 111 episodes for 2,758 patient days. Morphine doses had to be escalated when it was given to patients during end‐of‐life palliative care. Opioids were well tolerated with no severe side effects. Psychological dependence on morphine was found in 2% (2/111) of the cases. Pain control was satisfactory in 97% of the episodes. Conclusions The WHO guidelines for cancer pain relief were effective in controlling pain in children and adolescents with cancer. Despite their low socioeconomic level, patients were able to quantify their pain using rating scales. © 2003 Wiley‐Liss, Inc.