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Pain Management in Children With Cancer Using World Health Organization Guidelines at a Tertiary Cancer Center in

M S Biji, V Vinayagamoorthy, T K Jithin

    Journal of Pain & Palliative Care Pharmacotherapy
    |August 27, 2019
    PubMed

    Insights

    Pediatric cancer pain management in India is challenging. This study found that a significant number of children with hematologic malignancies experience pain, with older children often receiving weak opioids.

    Area of Science:

    • Oncology
    • Pediatrics
    • Pain Management

    Background:

    • Managing cancer pain in children presents unique challenges including pain perception, parental dependence, assessment complexity, and limited safe analgesic options.
    • Pain in pediatric cancer patients remains an under-researched area, particularly in India.

    Purpose of the Study:

    • To explore the characteristics of pain and its management in children with cancer at a tertiary cancer center.
    • To analyze pain prevalence and analgesic utilization in pediatric hematologic malignancies.

    Main Methods:

    • Retrospective cohort study analyzing patient records from January 2013 to December 2017.
    • Included children aged 4-18 years diagnosed with hematologic malignancies.
    • Examined 290 admission episodes, focusing on those associated with pain (93 episodes).

    Main Results:

    • 32.1% of admission episodes were associated with pain, with 15% primarily for pain management.
    • Step I analgesics were used in 83% of younger children (4-9 years).
    • Older children (10-18 years) significantly more often received Step 2 analgesics (tramadol, 58%) (P < .001); Step 3 analgesics were used in only 9.7% of episodes.

    Conclusions:

    • A substantial proportion of children with hematologic malignancies experience pain.
    • Pain management strategies differ by age group, with older children more frequently managed with weak opioids like tramadol.

    Keywords:
    Cancer painWHO pain guidelineschildrenpain assessment

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