7 research outputs found
Reducing pain in children with cancer: Methodology for the development of a clinical practice guideline
Abstract
Although pain is one of the most prevalent and bothersome symptoms children with cancer
experience, evidence-based guidance regarding assessment and management is lacking. With
44 international, multidisciplinary healthcare professionals and nine patient representatives, we
aimed to develop a clinical practice guideline (following GRADE methodology), addressing assessment and pharmacological, psychological, and physical management of tumor-, treatment-, and procedure-related pain in children with cancer. In this paper, we present our thorough methodology for this development, including the challenges we faced and how we approached these. This
lays the foundation for our clinical practice guideline, for which there is a high clinical demand
Nerve sheath catheter analgesia for forequarter amputation in paediatric oncology patients
In a single centre over two years, four children (7 to 10 years old) with upper limb osteosarcoma underwent chemotherapy followed by forequarter amputation. All patients had preoperative pain and were treated with gabapentin. Nerve sheath catheters were placed in the brachial plexus intraoperatively and left in situ for five to 14 days. After surgery, all patients received local anaesthetic infused via nerve sheath catheters as part of a multimodal analgesia technique. Three of the four patients were successfully treated as outpatients with the nerve sheath catheters in situ. All four children experienced phantom limb pain; however, it did not persist beyond four weeks in any patient.R. N. Kaddoum, L. L. Burgoyne, L. A. Pereiras, M. Germain, M. Neel, D. L. Anghelesc
Long-term use of nerve block catheters in paediatric patients with cancer related pathologic fractures
We report three cases of children with osteosarcoma and pathologic fractures treated with long-term continuous nerve blocks for preoperative pain control. One patient with a left distal femoral diaphysis fracture had a femoral continuous nerve block catheter for 41 days without complications. Another with a fractured left proximal femoral shaft had three femoral continuous nerve block catheters for 33, 26 and 22 days respectively. The third patient, whose right proximal humerus was fractured, had a brachial plexus continuous nerve block catheter for 36 days without complication. In our experience, prolonged use of continuous nerve block is safe and effective in children with pathologic fractures for preoperative pain control.L. L. Burgoyne, L. A. Pereiras, L. A. Bertani, R. N. Kaddoum, M. Neel, L. G. Faughnan, D. L. Anghelesc