Журнал «Медицина неотложных состояний» Том 16, №3, 2020
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Opiates or adjuvants? Pain management in children with cancer
Авторы: Adamchuk N.M.(1), Sorokina O.Y.(2)
(1) — Ukrainian Medical Stomatological Academy, Poltava, Ukraine
(2) — State Institution «Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine», Dnipro, Ukraine
Рубрики: Медицина неотложных состояний
Разделы: Медицинские форумы
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Background. The development of acute pain with neuropathy in children at the chemotherapy stages is one of the significant complications. The aim of the study was to analyze the pain syndrome in children with hemoblastoses at the first stage of chemotherapy and compare the effectiveness of various methods of pain treatment.
Materials and methods. A study was conducted of 60 children with hemoblastosis, aged 6 to 18 years. To assess the effectiveness of analgesia used pain scale, clinical and laboratory parameters.
Results. According to the data, the combination of paracetamol with gabapentin in the early stages of the development of acute pain was the most effective method of pain relief. The combination of morphine with gabapentin allowed to reduce the dose of opiate and the frequency of administration to achieve a therapeutic effect. In addition, in children receiving gabapentin, the formation of asthenic syndrome was manifested to a lesser extent. The pain intensity according to VAS on day 30 was in the I group (morphine) ≤ 5 points, in the II group (morphine with gabapentin) ≤ 4 points and in the III group (paracetamol with gabapentin) ≤ 3 points. On day 78, the intensity of pain in group I was ≤ 5 points, in groups II and III, ≤ 3 points.
Conclusions. The use of adjuvant analgesics in children with cancer has shown high efficiency by reducing the dose of opiates, reducing the duration of opiate use. Chronic pain was less pronounced in children receiving predominantly adjuvants in combination with paracetamol than in children receiving opiates.
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