Neuropathic pain in children with cancer.

Different mechanisms of cancer pain may involve somatic, visceral, and neural tissues. Pain that involves the neural tissues is classified as neuropathic pain and is less responsive to analgesics than pain that involves somatic and visceral tissues. Because young children are unable to describe the quality of pain, presence of neuropathic pain with cancer may be unrecognized and undetected. The purpose of this article is to explain the nature of neuropathic pain, to review the literature related to children with cancer that suggests the presence of neuropathic pain, to outline assessment strategies that may lead to appropriate detection of neuropathic pain in children, and to discuss challenges in the management of neuropathic pain. Future research is needed to characterize the intensity, location, quality, and duration of neuropathic pain in children. In addition, research that would determine the efficacy of opioids, nonsteroidal anti-inflammatory drugs, and adjuvant analgesics (antidepressants, anticonvulsants) is needed to increase the nurses' ability to assess and manage neuropathic pain in children with cancer.