Related Experiment Videos
[Patient-controlled analgesia for prolonged pain in the child. An open-label feasibility study of a standardized
Insights
Patient-controlled analgesia (PCA) is effective for children over five. A standardized PCA approach without background infusion showed good pain relief and sleep quality in pediatric patients.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Pharmacology
Background:
- Patient-controlled analgesia (PCA) is superior to continuous morphine infusion for children over five.
- PCA prescription parameters like bolus dosage and background infusion require standardization.
Purpose of the Study:
- To evaluate a standardized PCA technique in pediatric hematology patients.
- To assess morphine consumption, side effects, and pain relief efficacy.
Main Methods:
- Thirty-three children (aged 4-17) received PCA with a standardized prescription (≥25 mg/kg bolus, no background infusion).
- Morphine consumption, side effects, and pain relief were monitored.
Main Results:
- Median morphine consumption was 0.32 mg/kg/day (mean), 0.58 mg/kg/day (maximal).
- PCA was effective, comparable to continuous infusion, with good nocturnal sleep for 31 children.
- No significant side effects, except in two patients with pre-existing depression.
Conclusions:
- The standardized PCA technique is suitable for children over five years.
- This method can serve as a reference for future pediatric PCA studies.
Background:
Patient-controlled analgesia (PCA) has been shown to be superior to a continuous morphine infusion for the treatment of ongoing pain in children over five years of age. Nevertheless, prescription parameters such as the bolus dosage and the possible association of a continuous background infusion have not yet been standardized.
Patients And Methods:
Thirty-three children, aged four to 17, hospitalized in a pediatric hematology ward, benefited from PCA with a standardized prescription: a bolus dosage of at least 25 mg/kg, without a background infusion. Morphine consumption, side effects and efficacy on pain relief were followed.
Results:
Median of mean morphine consumption was 0.32 mg.kg-1.d-1. Median of maximal consumption was 0.58 mg.kg-1.d-1. Mean duration was nine days. No important side effects were noted, except in two patients. They presented prolonged constipation and a poor quality of nocturnal sleep, but they also had a major depressive syndrome persisting after resolution of pain. Efficacy was comparable to a continuous intravenous infusion, and nocturnal sleep was of good quality for 31 children.
Conclusion:
This standardized technique of PCA can be used extensively in children over five years of age. It can be used as a reference for further studies.