Abstract
Background: Methadone is an attractive medication for treating children with advanced cancer with pain as it is the only long-acting opioid available as a liquid. However, it is not frequently used due to concerns about potential toxicities and side effects. Objective: Evaluate the efficacy and safety of methadone as the first long-acting opioid in children with advanced cancer. Design: Retrospective chart review of 52 consecutive patients referred to Pediatric Supportive Care for pain management started on methadone as their first long-acting opioid. Data collected at baseline, follow-up visits #1 (F1) and #2 (F2) included child and parent-reported outcomes for various physical and psychological symptoms, opioid side effects and other clinical data. Symptoms were rated on a 0 (not at all) to 4 (a lot) scale. Results: Pain (mean ± standard deviation [SD]) scored by the child was 3.6 (±0.6)/4 at baseline and 1.8 (±1.1)/4 at F1 (p < 0.0001). Compared to baseline, pain scored by the child at F2 was 1.2 (±1.3)/4 (p < 0.0001). Pain scored by the parent was 3.5 (±0.7)/4 at baseline and 1.4 (±1.3)/4 at F1 (p < 0.0001). Compared to baseline, pain scored by the parent at F2 was 1.0 (±1.2)/4 (p < 0.0001). Thirty-three (70%) patients at F1 and 23 (79%) patients at F2 did not need a change in dose of methadone. No cardiac arrhythmias or opioid neurotoxicity was observed. Conclusions: Initiation of methadone was effective and safe as the first long-acting opioid in children with pain.
Original language | English (US) |
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Pages (from-to) | 1317-1321 |
Number of pages | 5 |
Journal | Journal of palliative medicine |
Volume | 21 |
Issue number | 9 |
DOIs | |
State | Published - Sep 2018 |
Keywords
- methadone
- opioid analgesics
- pediatric pain control
- pediatric palliative care
- symptom assessment
ASJC Scopus subject areas
- General Nursing
- Anesthesiology and Pain Medicine