Safety and efficacy of fentanyl administered by patient controlled analgesia in children with cancer pain.
BACKGROUND
Pain is the most common discomfort experienced by children with cancer and occurs in almost 89% of patients in an advanced stage of the disease. It is most often not adequately treated because of inexperience and unfounded fears of analgesic treatment. In adults, patient controlled analgesia (PCA) is widely administered, while in children with moderate to severe cancer pain its use is still under evaluation for safety and efficacy.


OBJECTIVE
To evaluate the efficacy and safety of fentanyl administered by PCA in children with cancer pain.


METHODS
Eighteen children (range 6 to 15 years) with moderate to severe pain were enrolled and treated with fentanyl by PCA plus background infusion (BI) (BI of 1 microg/kg/h with booster doses of 1 microg/kg by intravenous route). To evaluate efficacy and safety of the analgesic treatment, different subjective and objective parameters were monitored at 4-h intervals. In addition, patients' satisfaction was assessed by a questionnaire at the end of the treatment.


RESULTS
All children experienced a good degree of analgesia and did not require any other analgesic drug during the treatment. Both subjective and objective parameters improved after starting pain-relieving treatment and no major side effects occurred. The questionnaire administered to the children showed a high grade of satisfaction.


CONCLUSIONS
PCA plus BI with fentanyl administered by intravenous route is a safe and efficacious method for analgesia in children with moderate to severe cancer pain. Our policy of fentanyl-treatment did not show any major side effects.
Ruggiero
A
A
Division of Paediatric Oncology, Department of Paediatric Sciences, A Gemelli Hospital, Catholic University, Largo A Gemelli 8, Rome, Italy. ruggiero@rm.unicatt.it
Barone
G
G
Liotti
L
L
Chiaretti
A
A
Lazzareschi
I
I
Riccardi
R
R
D000293:Adolescent; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007558:Italy; D008297:Male; D009369:Neoplasms / Q000503:physiopathology*; D010146:Pain / Q000188:drug therapy*; D010358:Patient Participation; D011446:Prospective Studies; D012449:Safety; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D018686:Anesthetics, Intravenous; D005283:Fentanyl