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Association of analgesic pharmacological effect with pain site in pediatric oncology patients
Flavia Carvalho Marotta1, Eduardo Ladeia Leal2, Isabelle Alvarenga Oliveira1
1Department of Pharmacology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
Insights
Effective pain management in pediatric cancer patients was assessed. Dipyrone and morphine were effective when tailored to pain intensity and location, improving symptom control.
Area of Science:
- Pediatric Oncology
- Pain Management
- Pharmacology
Background:
- Pain is a common and distressing symptom in pediatric cancer patients.
- Effective pain management is a significant challenge for healthcare teams.
- Existing protocols have not fully addressed the need for tailored analgesic strategies.
Purpose of the Study:
- To evaluate the effectiveness of specific analgesics in pediatric cancer patients.
- To correlate analgesic efficacy with pain intensity and anatomical pain location.
Main Methods:
- A pharmacoepidemiological study analyzed medical records of pediatric oncology patients (0-17 years).
- Data included cancer diagnosis, analgesic use, pain intensity (before/after), and pain site.
- 1,465 pain episodes from 335 patients were reviewed.
Main Results:
- Dipyrone was effective for mild to moderate pain across various locations (abdomen, head, lower limbs).
- Morphine demonstrated effectiveness for severe to unbearable pain, particularly in the abdomen and lower limbs.
- Overall pharmacological effectiveness was observed across all patient subgroups and pain characteristics.
Conclusions:
- Tailored use of dipyrone and morphine based on pain intensity and location is effective.
- Optimizing symptom control in pediatric oncology requires individualized analgesic approaches.
- Findings support evidence-based selection of analgesics for pediatric cancer pain management.
Background:
Cancer in children and adolescents is frequently associated with pain, which is one of the most common and distressing symptoms reported by patients. Effective pain management remains a major concern for healthcare teams. Despite the availability of national and international pain management protocols since the mid-1980s, challenges persist in the assessment, treatment, and follow-up of pediatric patients. There is a lack of studies evaluating the most appropriate type and dosage of analgesics to achieve adequate pain control in pediatric oncology settings.
Objective:
The objective of this work was to assess the effectiveness of selected analgesics based on pain intensity and anatomical location in pediatric cancer patients.
Methods:
This pharmacoepidemiological study was conducted in a pediatric oncology hospital and included patients aged between 0 and 17 years with cancer who received analgesic drugs. Information regarding cancer diagnosis, hospitalization diagnosis, analgesic scale, pain intensity before and after drug administration, and pain site were collected from medical records.
Results:
A total of 1,465 episodes of pain from 335 patients were analyzed, most of them in patients diagnosed with leukemia (30.1%). We included 576 episodes of pain treated with dipyrone or morphine, occurring in the abdomen (n = 283), head (n = 155), and lower limbs (n = 138). The final pain scores indicated pharmacological effectiveness in all patient subgroups. When pain was mild to moderate, dipyrone was the most commonly used drug: 105 (65.2%) episodes of pain that occurred in the abdomen, 93 (86.9%) in the head, and 50 (64.1%) in the lower limbs. However, when the pain was severe to unbearable, morphine was the most commonly used drug: 79 (64.7%) episodes in the abdomen and 36 (60.6%) in the lower limbs, except when the pain occurred in the head (17 episodes of pain, 35.4%).
Conclusions:
The use of dipyrone and morphine, guided by pain intensities and locations, demonstrated effectiveness. These findings support the tailored use of analgesics according to pain characteristics to optimize symptom control in pediatric oncology patients.
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