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[PCA in the control of acute and chronic pain in children]
G Marchetti1, G Calbi, A Villani
1Ospedale Pediatrico Bambino Gesù, Servizio di Anestesiologia e Rianimazione, P.zza S.Onofrio, 4-00165 Roma, Italia.
Insights
Patient-controlled analgesia (PCA) effectively manages acute postoperative and chronic oncologic pain in children. This safe method provides satisfactory pain relief with minimal side effects, even in young children.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Oncology
Background:
- Acute postoperative pain and chronic oncologic pain are significant challenges in pediatric care.
- Patient-controlled analgesia (PCA) is a potential method for pain management in children.
Purpose of the Study:
- To evaluate the efficacy and safety of PCA for managing acute postoperative and chronic oncologic pain in children.
- To assess PCA's suitability for preschool-aged children (4-6 years) and older children.
Main Methods:
- Sixty-two children (aged 4-17 years) with postoperative or chronic pain received PCA with morphine.
- Dosages included bolus, starter dose, and background infusion, with lockout intervals of 5-15 minutes.
- Adjuvant drugs were used in some children with oncologic conditions.
Main Results:
- PCA provided satisfactory analgesia in all participants.
- Mild sedation occurred in two children; only one experienced transient respiratory depression.
- PCA was successfully implemented in 11% of preschool-aged children.
Conclusions:
- PCA is an effective and safe strategy for controlling acute postoperative pain in children.
- PCA is also a viable option for managing chronic oncologic pain in pediatric patients.
- The study supports the use of PCA across a wide age range in children.
Background:
This study was undertaken to verify the efficacy and safety of patient controlled analgesia (PCA) in preschool and older than 6 years children with acute postoperative and chronic oncologic pain.
Methods:
Sixty-two children, aged 4-17 yr, with postoperative (n = 37) or chronic (n = 25) pain received PCA with morphine at the following dosages: bolus = 10-20 gamma kg-1; starter dose = 10-30 gamma kg-1; background infusion = 10-50 gamma kg-1 h-1. Lockout was 5 to 15 minutes. In some children with oncologic pathology adjuvant drugs were also used.
Results:
Analgesia was considered satisfactory in all children, while a mild sedation was observed only in two children. PCA was also successfully used in preschool children (11%), aged 4 to 6 yr. Side effects were observed in 8 patients, but only in one of them a transient respiratory depression was recorded. The mean PCA duration was 5.3 +/- 5.5 days (min.2; max 24).
Conclusions:
These results indicate that PCA is an effective and safe method to control acute postoperative pain as well as to manage chronic oncologic pain in children.