Management of pediatric cancer pain

Faculty Medicine Year: 200642009
Type of Publication: Theses Pages: 120
BibID 10424746
Keywords : Management of pediatric cancer pain    
Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Pain is protective mechanism for the body. It causes the individual to remove the painful stimuli, so prevent tissue. Pain in the cancer patient results from direct tumor infiltration, from the various cancer treatments and can occur unrelated to the cancer and cancer therapy.Pain assessment in children is difficult so that multiple pain assessment scales has developed. Pain can be assessed by:1. Self-report (what children say).2. Biological markers (how their bodies react),3. and behavioral methods (what children do).Management of cancer pain can be divided according to causes in to:1. Management of Procedure – related pain:This is includes topical local anesthetics, intravenous sedation, transmucosal drug and nitrous oxide.2. Management of Treatment related pain:This is includes treatment of mucositis, post operative pain, infection.3-Management of cancer related pain:This is include a complex mechanism which depend on severity of pain followed by choose the appropriate drugs which depend on what is called stepladder of WHO which divide pain to 3 categories:Step 1: Mild pain: NSAIDs and Paracetamol are the drugs of choice.Step 2: Moderate pain: where weak opioid with NSAIDs are used as codeine or hydrocodoneStep 3: Severe pain: strong opioid and intervention therapy are used morphine, hydromorphone, methadone, fentanyl, or levorphanol.Medications for persistent cancer-related pain should be administered on an around-the-clock basis, with additional ”as needed” doses.Adjuvant drugs are used to enhance the analgesic efficacy of opioids, treat concurrent symptoms that exacerbate pain, and provide independent analgesic activity for specific types of pain. They may be used at all steps of the analgesic ladder. The most commonly used include corticosteroid agents, anticonvulsant agents, antidepressant agents, neuroleptic agents, and hydroxyzine.