Opioids for the management of severe chronic nonmalignant pain in children: a retrospective 1-year practice survey in a children's hospital.
OBJECTIVE
This study reviewed opioid prescription for chronic severe nonmalignant pain in a multidisciplinary pediatric pain clinic. We looked at benefits and side effects of therapy, and compared our process of opioid prescription with the practice guidelines defined in adult literature.


METHODS
Descriptive retrospective practice survey.


METHODS
Multidisciplinary pain clinic in a tertiary pediatric hospital.


METHODS
During a 12-month period, 104 patients were seen in the clinic, of which 49 received an opioid as part of their pain management; 11 received an opioid chronically, defined as more than 3 months in this study, and 5 of these were still on opioid at the end of the study period although data on one patient are lacking as she had been transferred to an adult clinic.


METHODS
Information about patients was obtained from chart review.


METHODS
Benefits and side effects of treatment, as well as the process of prescribing opioids and follow-up.


RESULTS
In the four patients studied, there seem to be better pain control and improved function in these patients while on opioid therapy, despite minor side effects. We identified some areas of improvement in our practice and made recommendations for the use of opioids in pediatric chronic severe nonmalignant pain.


CONCLUSIONS
The evolution of our four patients seems to be in favor of treatment with an opioid for severe chronic nonmalignant pain in certain pediatric patients, in the context of prescribing in a multidisciplinary pain clinic with a multisystem approach to pain management although more data are needed to know if such therapy is safe and beneficial on a longer-term basis.
Slater
Marie-Eve
ME
Department of Pain Medicine and Palliative Care, The Children's Hospital at Westmead, Westmead, New South Wales, Sydney, Australia.
De Lima
Jonathan
J
Campbell
Kirsty
K
Lane
Lyn
L
Collins
John
J
D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002908:Chronic Disease; D003248:Constipation / Q000139:chemically induced; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D010146:Pain / Q000188:drug therapy*; D018710:Pain Clinics; D010147:Pain Measurement / Q000187:drug effects; D010348:Patient Care Team; D012189:Retrospective Studies; D012919:Social Behavior; D016896:Treatment Outcome
D000701:Analgesics, Opioid