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Related Experiment Videos

Pain and symptom control in paediatric palliative care

M M Stevens1, L Dalla Pozza, B Cavalletto

  • 1Oncology Unit, Royal Alexandra Hospital for Children, Camperdown, Sydeny.

Cancer Surveys
|January 1, 1994
PubMed
Summary

Effective pediatric cancer pain management requires accurate assessment and multidisciplinary approaches, addressing unique challenges in children, including opioid side effects and procedural pain. Continued research and improved palliative care practices are essential for optimal symptom control.

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Area of Science:

  • Pediatric Oncology
  • Palliative Care
  • Pain Management

Background:

  • Cancer pain in children differs significantly from adults due to developmental immaturity and dependence.
  • Despite advancements, optimal pain management in children, especially preverbal ones, remains a challenge.
  • Opioid side effects like sedation and tolerance require specific management strategies in terminally ill children.

Purpose of the Study:

  • To highlight key differences in cancer pain management between children and adults.
  • To review current practices and identify areas for improvement in pediatric palliative pain care.
  • To discuss challenges and strategies for managing various types of pain, including neuropathic and procedural pain, in children with cancer.

Main Methods:

  • Comparative analysis of pediatric versus adult cancer pain management approaches.

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  • Review of advancements in pain assessment techniques for children.
  • Discussion of pharmacological and non-pharmacological interventions for pediatric cancer pain.
  • Exploration of challenges in palliative care, including home nursing and psychosocial support.

    • Main Results:

    • Pediatric pain management is often multidisciplinary, relying more on systemic therapy than invasive measures.
    • Accurate pain assessment is crucial, though challenging in preverbal children.
    • Opioid side effects (sedation, tolerance) and neuropathic pain require specific attention and advanced techniques like regional anesthesia.
    • Procedural pain is common, with nitrous oxide showing benefit, and non-pharmacological methods warrant further evaluation.

    Conclusions:

    • Optimizing pediatric cancer pain management necessitates accurate assessment, multidisciplinary care, and addressing unique pediatric challenges.
    • Further research is needed for effective treatment of neuropathic pain and procedural pain in children.
    • Improving palliative care services, including home support and staff training, is vital for holistic care.
    • Ethical considerations like euthanasia are complex, with optimal symptom control being the priority.