Department of Pain Medicine and Palliative Care, The Children's Hospital at Westmead, Westmead, New South Wales, Sydney, Australia.
Pain Med. 2010 Feb;11(2):207-14. doi: 10.1111/j.1526-4637.2009.00754.x. Epub 2009 Dec 9.
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.
Descriptive retrospective practice survey.
Multidisciplinary pain clinic in a tertiary pediatric hospital.
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.
Information about patients was obtained from chart review.
Benefits and side effects of treatment, as well as the process of prescribing opioids and follow-up.
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.
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.
本研究回顾了多学科儿科疼痛诊所中慢性严重非恶性疼痛的阿片类药物处方。我们研究了治疗的益处和副作用，并将我们的阿片类药物处方流程与成人文献中定义的实践指南进行了比较。
描述性回顾性实践调查。
三级儿童医院多学科疼痛诊所。
在 12 个月的时间里，有 104 名患者在诊所就诊，其中 49 名患者接受了阿片类药物作为其疼痛管理的一部分；11 名患者长期接受阿片类药物治疗，在本研究中定义为超过 3 个月，其中 5 名患者在研究结束时仍在接受阿片类药物治疗，尽管其中一名患者的数据缺失，因为她已转至成人诊所。
从病历回顾中获取患者信息。
在研究的 4 名患者中，尽管存在轻微的副作用，但在接受阿片类药物治疗时，这些患者的疼痛控制似乎更好，功能也有所改善。我们确定了我们实践中的一些改进领域，并为儿科慢性严重非恶性疼痛中使用阿片类药物提出了建议。
我们的 4 名患者的病情发展似乎支持在多学科疼痛诊所中，针对特定儿科患者的严重慢性非恶性疼痛使用阿片类药物治疗，采用多系统方法进行疼痛管理，尽管需要更多数据来了解这种治疗在长期内是否安全和有益。
