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Original article| Volume 10, ISSUE 8, P604-611, November 1995

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Use of patient-controlled analgesia for pain control for children receiving bone marrow transplant

  • Peter J. Dunbar
    Correspondence
    Address reprint requests to: Peter J. Dunbar, MB, ChB, Fred Hutchinson Cancer Research Center, 1124 Columbia Street, FB635, Seattle WA 98104, USA.
    Affiliations
    Pain and Toxicity Research Program, Division of Clinical Research, Fred Hutchinson Cancer Research Center, and Department of Anesthesiology, University of Washington School of Medicine, Seattle, Washington U.S.A.
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  • Peter Buckley
    Affiliations
    Pain and Toxicity Research Program, Division of Clinical Research, Fred Hutchinson Cancer Research Center, and Department of Anesthesiology, University of Washington School of Medicine, Seattle, Washington U.S.A.
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  • Jonathan R. Gavrin
    Affiliations
    Pain and Toxicity Research Program, Division of Clinical Research, Fred Hutchinson Cancer Research Center, and Department of Anesthesiology, University of Washington School of Medicine, Seattle, Washington U.S.A.
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  • Jean E. Sanders
    Affiliations
    Pain and Toxicity Research Program, Division of Clinical Research, Fred Hutchinson Cancer Research Center, and Department of Anesthesiology, University of Washington School of Medicine, Seattle, Washington U.S.A.
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  • C.Richard Chapman
    Affiliations
    Pain and Toxicity Research Program, Division of Clinical Research, Fred Hutchinson Cancer Research Center, and Department of Anesthesiology, University of Washington School of Medicine, Seattle, Washington U.S.A.
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      Abstract

      We report 2 years' experience managing 39 preteen (ages 4–12 years) children with patient-controlled analgesia (PCA) for pain associated with bone marrow transplantation (BMT). We prescribed morphine or hydromorphine PCA (starting bolus 20 μg/kg morphine or 2 μg/kg hydromorphone) with or without continuous infusion (CI), for a period of 6–74 days. The duration of PCA use (median 19 days) depended upon severity of mucositis or other painful conditions. The peak morphine use was on the 11th day after BMT. We prescribed CI opioids in addition to PCA, either at night or around the clock, in 52% of patients. Ninety-five percent of children successfully mastered PCA to control pain associated with BMT. We observed no instances of drug misuse, parental tampering, accidental overdose, or difficulty weaning from opioids. We conclude that opioid PCA, with or without CI, over several days or weeks is safe and effective for preteen children suffering BMT-related pain.

      Keywords

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