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[Treating hospitalized children in severe pain with oral methadone]
1Dept. of Anesthesiology, Hadassah University Hospital, Jerusalem.
Insights
Oral methadone effectively manages severe pain in hospitalized children, offering significant relief with minimal side effects. This opioid provides a viable alternative for pediatric patients unable to receive intravenous pain medication.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Pharmacology
Background:
- Inadequate pain relief is a significant issue for hospitalized children, often stemming from suboptimal analgesic drug use.
- Oral analgesics are crucial for pediatric patients who can tolerate oral intake, yet effective options for severe pain remain limited.
Observation:
- Oral methadone (0.1% syrup, 0.2-0.4 mg/kg/day) was administered to over 70 children (8 months to 9 years) for severe pain (burns, cancer).
- Treatment duration varied from days to over a month, with successful administration in patients able to take oral medication.
Findings:
- The majority of pediatric patients experienced significant pain relief with oral methadone.
- No serious adverse effects were observed, and some patients transitioned to parent-controlled analgesia without complications.
Implications:
- Oral methadone presents a safe and effective option for managing severe pain in hospitalized children.
- This approach may improve pain control and quality of life for pediatric patients, potentially reducing the need for other opioid analgesics.
Abstract:
Pain relief is usually inadequate in hospitalized patients, especially in children, either after surgery or with various medical conditions. Among other reasons, this is due to suboptimal use of available analgesic drugs. In the past 2 years oral methadone has become our opioid of choice for severe pain in hospitalized children who can take oral medication. More than 70 babies and children, aged 8 months to 9 years, who suffered mainly from pain due to burns or cancer, were treated by the in-hospital pain service. They received 0.1% methadone syrup, 0.2-0.4 mg/kg/day, for from a few days to more than a month. In most there was significant pain relief with no serious side-effects. In some, treatment could be changed to parent-controlled analgesia after a few days, with no adverse effects. We describe 5 of the children who present the advantages of oral methadone over other opioids.