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Regional blocks for pain control at the end of life in pediatric oncology

Andrea Cuviello1, Ashley Cianchini de la Sota2, Justin Baker1

  • 1Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, United States.

Frontiers in Pain Research (Lausanne, Switzerland)
|April 7, 2023
PubMed

Insights

Regional pain management, including continuous nerve blocks, effectively reduced pain scores in pediatric cancer patients at the end of life. Collaboration with palliative care specialists improved quality of life.

Area of Science:

  • Oncology
  • Pain Management
  • Palliative Care

Background:

  • End-of-life pain management is crucial for improving pediatric cancer patients' quality of life.
  • Interventional pain management techniques may be underutilized in this population.

Purpose of the Study:

  • To evaluate a single institution's 10-year experience with regional pain management in pediatric oncology patients at the end of life.
  • To assess the efficacy and safety of nerve blocks for pain control in this cohort.

Main Methods:

  • Retrospective cohort study of 27 pediatric cancer patients who died between April 2011 and December 2021.
  • Patients received continuous nerve block (CNB) catheters or single-shot nerve blocks (SSBs) in the last three months of life.
  • Evaluated block types, analgesic efficacy, and palliative care involvement.

Main Results:

  • Most patients (81.5%) had solid tumors. CNB catheters were used in 59% and SSBs in 44% of patients.
  • Mean pain score reductions were -2.5 for CNB and -2.8 for SSB on an 11-point scale.
  • Reduced opioid requirements were observed in 56% of CNB patients and 25% of SSB patients at 24 hours.

Conclusions:

  • Regional pain control interventions are effective and safe for managing pain in dying children and young adults.
  • Collaboration between palliative care and pain management specialists enhances end-of-life care and quality of life.
Abstract

Keywords:
continuous nerve blockend of lifepain managementpalliative carepediatric oncologysingle-shot nerve block

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