Severe pain treatment of children in the terminal stages of malignant diseases: case raport

Abstract

Severe pain control is an indispensable and important part of the treatment of children with malignant diseases. The specificity of treatment is connected to the opiate’s metabolism, but it is more difficult to estimate pain and there is fear of side effects, which leads to sub-dosing and poor analgesia. The aim of this study is to show that rational use of opiates secures efficient pain suppression in children in the terminal phase of malignant diseases. Oral morphine with fast impact is the gold standard in the initial phase of severe cancer pain therapy and for the treatment of shooting pain in children. Slow release opiates are suitable for long-term use, as they combine efficiency and compatibility. Rotation of fentanyl transdermal allows simpler usage, decreases side-effects and provides good analgesia for children who cannot take opiates orally. Along with an individual estimate of the child’s condition, it is important to take care of equianalgetic doses of opiates and support therapy.