Document Detail


Methadone analgesia for children with advanced cancer.
MedLine Citation:
PMID:  18428431     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Methadone is frequently used in the treatment of adults with advanced cancer. A criticism of relevant research is the use of single or fixed doses, which does not reflect use in clinical practice. Literature about use of methadone in the treatment of pediatric patients is limited to case reports. The objective of this study is to describe methadone use as primary opioid analgesic for advanced pediatric cancer over a 6.5-year period. PROCEDURE: All 17 patients who received methadone as their primary opioid analgesic through the Northern Alberta Children's Cancer Program from January 2000 to June 2007 were included. Children who received combination opioid therapy were excluded. RESULTS: Rotation to methadone was usually by a complete switch from primary opioid. Conversion ratios of morphine equivalent daily dose (MEDD)/methadone daily dose (TMDD) ranged widely from 1:2 in one patient with sudden pain crisis just prior to death, to 60:1 in a patient who had been treated with opioids for months. Methadone was used for a total of 925 patient-days. There were no significant adverse events in any patient, and all but one patient remained on methadone until the time of their death. Clinically, the effectiveness of analgesia clearly improved at time of conversion in 16 patients. CONCLUSION: With close monitoring, methadone therapy can be done safely in pediatric oncology patient populations in both inpatient and outpatient settings. Our experience suggests improvement in analgesia with the use of methadone, with 16 patients remaining on methadone until they died.
Authors:
Dawn Davies; Deborah DeVlaming; Christina Haines
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric blood & cancer     Volume:  51     ISSN:  1545-5017     ISO Abbreviation:  Pediatr Blood Cancer     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-07-22     Completed Date:  2008-08-13     Revised Date:  2009-01-12    
Medline Journal Info:
Nlm Unique ID:  101186624     Medline TA:  Pediatr Blood Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  393-7     Citation Subset:  IM    
Copyright Information:
(c) 2008 Wiley-Liss, Inc.
Affiliation:
Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada. dawn.davies@capitalhealth.ca
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Analgesia / methods*
Analgesics, Opioid
Child
Child, Preschool
Drug Evaluation
Drug Toxicity
Female
Humans
Infant
Inpatients
Male
Methadone / administration & dosage*
Neoplasms / drug therapy*
Outpatients
Palliative Care / methods
Retrospective Studies
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 76-99-3/Methadone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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