Management of pain in leukemic children using the WHO analgesic ladder.

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dc.contributor.authorGeeta, M G
dc.contributor.authorGeetha, P
dc.contributor.authorAjithkumar, V T
dc.contributor.authorKrishnakumar, P
dc.contributor.authorKumar, K Suresh
dc.contributor.authorMathews, Lulu
dc.date.accessioned2012-10-30T07:30:56Z
dc.date.available2012-10-30T07:30:56Z
dc.date.issued2010-06
dc.description.abstractObjective. To ascertain the effectiveness of WHO analgesic ladder in pain management in children with leukemia. Methods. Children with leukemia who were referred to a pain and palliative care clinic attached to the Department of Pediatrics of a medical teaching hospital during a period of 6 months, were included in the study. Results. Thirty nine (39) children, who constituted 64% of children on treatment for leukemia, required referral to pain and palliative care services during the study period. Of these 92% had Acute Lymphocytic Leukemia (ALL) and 8% had Acute Non Lymphocytic Leukemia (ANLL). 95% of children had nociceptive pain and 5% had neuropathic pain. Step – 1 analgesia was effective in 12 (31%) children and 21 (54%) could be managed with Step – 2 analgesia. Step – 3 analgesia was required in only 6 (15%) children. Step 3 analgesia was required in children with neuropathic pain and bone pain. Conclusions. WHO analgesic ladder is effective in managing pain in children with leukemia. Majority of cases of cancer pain in children could be managed by the treating physician using non-opioids, weak opioids and adjuvants as per the WHO guidelines. Children with bone pain and neuropathic pain may require referral to specialist services and use of strong opioids like morphine. The study emphasizes the need for establishing specialist pain management services in all centres where children with cancer are treated.en_US
dc.identifier.citationGeeta M G, Geetha P, Ajithkumar V T, Krishnakumar P, Kumar K Suresh, Mathews Lulu. Management of pain in leukemic children using the WHO analgesic ladder. Indian Journal of Pediatrics. 2010 June; 77(6): 665-668.en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/142602
dc.language.isoenen_US
dc.source.urihttps://medind.nic.in/icb/t10/i6/icbt10i6p665.pdfen_US
dc.subjectChildrenen_US
dc.subjectLeukemiaen_US
dc.subjectPainen_US
dc.subjectWHO analgesic ladderen_US
dc.subject.meshAdolescent
dc.subject.meshAnalgesia --methods
dc.subject.meshAnalgesics --therapeutic use
dc.subject.meshAnalgesics, Opioid --therapeutic use
dc.subject.meshCancer Care Facilities
dc.subject.meshChild
dc.subject.meshChild, Preschool
dc.subject.meshDisease Management
dc.subject.meshFemale
dc.subject.meshGuideline Adherence
dc.subject.meshHumans
dc.subject.meshInfant
dc.subject.meshLeukemia, Myeloid, Acute --complications
dc.subject.meshMale
dc.subject.meshPain --drug therapy
dc.subject.meshPain --etiology
dc.subject.meshPain, Intractable --drug therapy
dc.subject.meshPalliative Care --methods
dc.subject.meshPractice Guidelines as Topic
dc.subject.meshPrecursor Cell Lymphoblastic Leukemia-Lymphoma --complications
dc.subject.meshRetrospective Studies
dc.subject.meshTime Factors
dc.subject.meshTreatment Outcome
dc.subject.meshWorld Health Organization
dc.titleManagement of pain in leukemic children using the WHO analgesic ladder.en_US
dc.typeArticleen_US
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