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[Long-term pediatric opioid based pain control. Case reports]
B Zernikow1, C Schiessl, C Wamsler
1Institut für Kinderschmerztherapie und Pädiatrische Palliativmedizin, Vestische Kinder- und Jugendklinik Datteln der Universität Witten/Herdecke. Boris.Zernikow@t-online.de
Schmerz (Berlin, Germany)
|August 5, 2005
Summary
Long-term pediatric opioid pain management is safe and effective in infants when dosed appropriately. Proven adult strategies can be adapted for children, considering their unique physiology.
Area of Science:
- Pediatric Pain Management
- Pharmacology
- Oncology
Background:
- Long-term opioid therapy is crucial for managing chronic pain in children.
- Understanding pediatric-specific pharmacokinetic and pharmacodynamic properties is essential for safe and effective opioid use.
- Case reports highlight various aspects of pediatric opioid pain control.
Observation:
- Case 1: Oral sustained-release opioids are safe for infants under one year with proper weight-based dosing.
- Case 2: Buccal fentanyl citrate demonstrates efficacy for breakthrough pain in pediatric patients.
- Case 3: Opioid therapy can cause adverse effects in neurologically impaired infants.
- Case 4: Transdermal buprenorphine effectively manages tumor-related pain in a pediatric case.
Findings:
- Adequate opioid dosing, considering body weight, is critical for safe and effective pediatric pain control.
- Various opioid formulations, including oral sustained-release, buccal, and transdermal, show promise in pediatric pain management.
- Individual patient factors, such as neurological impairment, can influence opioid therapy outcomes.
Implications:
- Established adult opioid pain management strategies can be adapted for pediatric use.
- Tailoring treatment to pediatric pharmacokinetic and pharmacodynamic profiles is mandatory for optimizing outcomes.
- Further research into safe and effective long-term opioid use in children is warranted.