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PCA analgesia for children with chemotherapy-related mucositis: a double-blind randomized comparison of morphine and

Caroline Oudot1, Agnès Laplanche, Daniel Orbach

  • 1Hôpital Mère-Enfant, Pediatric Oncology, Limoges, France. oudot_caroline@yahoo.fr

Bulletin Du Cancer
|February 23, 2011
PubMed

Insights

Pethidine patient-controlled analgesia (PCA) showed comparable pain relief to morphine in children with severe mucositis. Pethidine PCA resulted in less constipation, suggesting a potentially better toxicity profile.

Area of Science:

  • Pediatric Oncology
  • Pain Management
  • Pharmacology

Background:

  • Severe mucositis is a painful side effect of chemotherapy in children.
  • Effective pain management is crucial for improving quality of life during cancer treatment.

Purpose of the Study:

  • To compare the efficacy and toxicity of pethidine versus morphine for managing severe chemotherapy-induced mucositis pain in pediatric patients.
  • To evaluate patient-controlled analgesia (PCA) delivery methods for pain control in this population.

Main Methods:

  • A randomized, double-blind study involving 35 hospitalized children with chemotherapy-related mucositis.
  • Patients received either morphine or pethidine via PCA, with pain assessed using a Visual Analogue Scale (VAS) from day 2 to 5.
  • Study recruitment was challenging, leading to early termination.

Main Results:

  • Twenty-nine patients completed sufficient PCA for analysis; pain scores were similar between morphine and pethidine groups (median VAS 44 vs. 33, P=0.32).
  • PCA was discontinued due to treatment failure in five patients from each group.
  • Constipation requiring treatment was significantly higher in the morphine group (43%) compared to the pethidine group (0%).

Conclusions:

  • Pethidine PCA demonstrated non-inferior efficacy to morphine for severe mucositis pain in children.
  • Pethidine PCA was associated with a lower incidence of constipation, indicating a potentially favorable toxicity profile.
  • A larger, adequately powered study is recommended to confirm these findings.
Abstract

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