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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.
- Acute Pain Management: Operative or Medical Procedures and Trauma. Clinical Practice Guideline. Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, Rockville, MDFeb. 1992 (AHCPR Pub. No. 92-0032)
- Pain control in pediatric burns—the use of patient-controlled analgesia.Burns. 1991; 17: 396-399
- Management of Cancer Pain. Clinical Practice Guideline. Agency for Health Care Policy and Research, U.S. Department of Health and Human Services, Public Health Service, Rockville, MDMarch 1994 (No. 9. AHCPR Publication No. 94-0592)
- PCA for adolescents in sickle-cell crisis.Am J Nurs. 1988; 88: 719
- Patient-controlled analgesia for sickle-cell-related pain.J Pain Symptom Manage. 1993; 8: 22-28
- Patient controlled analgesia in children and adolescents: a report of postoperative pain management in 150 patients.Anesthesiology. 1989; V71: A1170
- Patient-controlled analgesia for children: a review.Paediatr Anaesth. 1992; 2: 51-59
- Patient-controlled analgesia in adolescents.J Adolesc Health Care. 1990; 11: 154-158
- Pediatric patient-controlled analgesia with morphine versus meperidine.J Pain Symptom Manage. 1992; 7: 204-208
- Patient-controlled versus conventional analgesia for postsurgical pain relief in adolescents.Dev Pharmacol Ther. 1992; 19: 32-39
- Pediatric PCA: the role of concurrent opioid infusions and nurse-controlled analgesia.Clin J Pain. 1993; 9: 26-33
- The use of patient-controlled analgesia in adolescents with sickle cell pain crisis: a preliminary report.J Pain Symptom Manage. 1988; 3: 109-113
- Adolescents use patient-controlled analgesia effectively for relief from prolonged oropharyngeal mucositis pain.Pain. 1991; 46: 265-269
- Long-term patient-controlled analgesia in children.Anaesthesia. 1990; 45: 941-943
- Longer duration PCA opioids in children (6–12) for bone marrow transplant related pain.American Pain Society (APS) 12th Annual Scientific Meeting in Orlando, FL. 1993;
- Parent assisted “PCA” for postoperative pain control in young children.Anesth Analg. 1990; 70: S34
- Patient-controlled analgesia with low dose background infusions after lower abdominal surgery in children.Br J Anaesth. 1993; 71: 818-822
- Comparison of patient-controlled analgesia with and without a background infusion after lower abdominal surgery in children.Br J Anaesth. 1993; 71: 670-673
Accepted: April 10, 1995
© 1995 Published by Elsevier Inc.