2015, Number 2
<< Back
Rev Cubana Farm 2015; 49 (2)
Pain management in the pediatric oncological patient and factors influencing its perception
Gallego MC, Martínez BMJ, Guerrero NN, Romero HI, García MF, Manzano MMV
Language: Spanish
References: 121
Page: 394-411
PDF size: 148.89 Kb.
ABSTRACT
Pain is a subjective characteristic found in many patients during their hospital stay.
Pediatric population presents physiological and psychological characteristics
different from those of the adults. Added to this, if a cancer process is present, for
which they are subjected to numerous painful experiences during their diagnosis
and treatment, adequate pain management is vital. The objective of this paper was
to review the main factors that influence the perception of cancer pain in the
pediatric patient and both non-pharmacological and pharmacological measures that
are necessary to take into account for proper pain management. To this end, a
literature review was made in
MEDLINE database, which covered the scientific
publications of the last 25 years. It can be concluded that oncological pain
perception has a multifactoral component. Furthermore, in addition to appropriate
use of pharmacologic measures, non-pharmacological actions are very important
for a comprehensive approach to pain.
REFERENCES
Schechter NL, Berstein BA, Beck A, Hart L and Scherzer L. Individual differences in children's response to pain: Role of temperament and parental characteristics. Pediatrics. 1991;87(2):171-7.
Miller C and Newton S. Pain perception and expression: The influence of gender, personal self-efficacy, and lifespan socialization. Pain Management Nursing. 2006;7(4):148-52.
Lee LW and White-Traut RC. The role of temperament in pediatric pain response. Issues in Comprehensive Pediatric Nursing. 1996;19:49-63.
Broome ME, Rehwaldt M and Fogg L. Relationships between cognitive behavioral techniques, temperament, observed distress, and pain reports in children and adolescents during lumbar puncture. Journal of Pediatric Nursing. 1998;13(1):48-54.
Johnston CC, Stevens BJ, Boyer K and Lang Porter F. Development of psychologic responses to pain and assessment of pain in infants and toddlers. In: NL Schechter, CB Berde and M Yaster, Pain in infants, children and adolescents (2nd ed.). Philadelphia, PA: Lippincott Williams and Wilkins; 2003.
Kim H, Neubert JK, San Miguel A, Xu K, Krishnaraju RK and Iadarola MJ, et al. Genetic influence on variability in human acute experimental pain sensitivity associated with gender, ethnicity and psychological temperament. Pain. 2004;109:488-96.
Miller C and Newton S. Pain perception and expression: The influence of gender, personal self-efficacy and lifespan socialization. Pain Management Nursing. 2006;7(4):148-152.
Twycross A. Pain: a bio-psycho-social phenomenon. In: A Twycross, S Dowden, and E Bruce. Managing pain in children: a clinical guide. Oxford, UK: Wiley- Blackwell; 2009. p. 29-38.
Kim H, NeubertJK, San Miguel A, Xu K, Krishnaraju RK and Iadarola MJ, et al. Genetic influence on variability in human acute experimental pain sensitivity associated with gender, ethnicity and psychological temperament. Pain. 2004;109:488-96.
Zubieta JK, Heitzeg MM, Smith YR, Bueller JA, Xu K and Xu Y, et al. COMT val158met genotype affects mu-opioid neurotransmitter responses to a pain stressor. Science. 2003;299:1240-3.
Kambur O and Mannisto PT. Catechol O-Methyltransferase and pain. International Review of Neurobiology. 2010;95:227-79.
Muralidharan A and Smith MT. Pain, analgesia and genetics. Journal of Pharmacy and Pharmacology. 2011;63(11):1387-1400.
Martínez-Jauand M, Sitges C, Rodríguez V, Picornell A, Ramon M, Buskila D and Montoya P. Pain sensitivity in fibromyalgia is associated with catechol-Omethyltransferase (COMT) gene. European Journal of Pain. 2012;17(1):16-27.
Miawskoski C. Understanding the genetic determinants of pain and pain management. Seminars in Oncology Nursing. 2009;25(2):S1-S7.
Turabi A and Plunkett AR. The application of genomic and molecular data in the treatment of chronic cancer pain. Journal of Surgical Oncology. 2012;105(5):494-501.
Rakvag TT, Ross JR, Sato H, Skorpen F, Kaasa S and Klepstad P. Genetic variation in the catechol-O-methyltransferase (COMT) gene and morphine requirements in cancer patients with pain. Molecular Pain. 2008;4(64).
Zeltzer LK, Fanurik D and LeBaron S. The cold pressor pain paradigm in children: feasibility of an intervention model (Part II). Pain. 1989;37(3):305-313.
Conner-Warren RL. Pain intensity and home pain management of children with sickle cell disease. Issues in Comprehensive Pediatric Nursing. 1996;19(3):183-95.
Goodenough B, Thomas W, Champion DG, Perrott D, Taplin JE, von Baeyer CL and Ziegler JB. Unravelling age effects and sex differences in needle pain: ratings of sensory intensity and unpleasantness of venipuncture pain by children and their parents. Pain. 1999;80(1):179-90.
McGrath PA. Pain in children: nature, assessment and treatment (2nd ed.). 1990. New York: The Guilford Press.
Palermo TM and Drotar D. Prediction of children’s postoperative pain: the role of presurgical expectations and anticipatory emotions. Journal of Pediatric Psychology. 199;21:683-98.
Abu-Saad HH, Kroonen E and Halfens R. On the development of a multidimensional Dutch pain assessment tool for children. Pain. 1990;43:249-56.
Harbeck C and Peterson L. Elephants dancing in my head: A developmental approach to children’s concepts of specific pains. Child Development. 1992;63(1):138-49.
Ross DM and Ross SA. Childhood pain: the school-aged child’s viewpoint. Pain. 1984;20:179-91.
Gaffney A and Dunne EA. Children’s understanding of the causality of pain. Pain. 1987;29:91-104.
Fowler-Kerry S and Lander J. Assessment of sex differences in children's and adolescents' self-reported pain from venipuncture. Journal of Pediatric Psychology. 1991;16(6):783-93.
Bournaki MC. Correlates of pain-related responses to venipunctures in schoolage children. Nursing Research. 1997;46:147-54.
Carr TD, Lemanek KL and Armstrong FD. Pain and fear ratings: clinical implications of age and gender differences. Journal of Pain and Symptom Management. 1998;15:305-13.
Gauthier J, Finley GA, FRCPC and McGrath P. Children's Self-Report of Postoperative Pain Intensity and Treatment Threshold: Determining the Adequacy of Medication. Clinical Journal of Pain. 1998;14(2):116-20.
Zahr L and Hattar-Pollara M. Nursing care of Arab children: Consideration of cultural factors. Journal of Pediatric Nursing. 1998;13:349-55.
Jacob E, Hesselgrave J, Sambuco G and Hockenberry M. Variations in pain, sleep, and activity during hospitalization in children with cancer. Journal of Pediatric Oncology Nursing. 2007;24;208-19.
Kurdahi Badr (Zahr) L, Puzantian H, Abboud M, Abdallah A and Shahine R. Assessingprocedural pain in children with cancer in Beirut, Lebanon. Journal of Pediatric Oncology Nursing. 2006;23(6):311-20.
Walco GA, Conte PM, Labay LE, Engel R and Zeltzer LK. Procedural distress in children with cancer. Self-report, behavioral observation, and physiological parameters. Clinical Journal of Pain. 2005;21:484-90.
Hechler T, Chalkiadis GA, Hasan C, Kosfelder J, Meyerhoff U, Vocks S and Zernikow B. Sex differences in pain intensity in adolescents suffering from cancer: differences in pain memories? The Journal of Pain. 2009;10(6):586-93.
Firoozi M and Rostami R. Sensitivity to pain in children with acute lymphoblastic leukemia (ALL). Iranian Journal of Cancer Prevention. 2012;5(2):74-80.
Van Cleve L, Bossert E, Beecroft A, Adlard K, Alvarez O and Savedra MC. The pain experience of children with leukemia during the first year after diagnosis. Nursing Research. 2004;53(1):1-10.
Gallagher JM and Reid DK. The learning theory of Piaget and Inhelder. Monterey, 1981; CA: Brooks/Cole Publishers.
Gaffney A and Dunne EA. Developmental aspects of children’s definitions of pain. Pain. 1986;26:105-17.
Crow CS. Children's Pain Perspectives Inventory (CPPI): developmental assessment. Pain. 1997;2(1-2):33-40.
Cheng SF, Foster RL, Hester NO and Huang CY. A qualitative inquiry of Taiwanese children’s pain experiences. Journal of Nursing Research. 2003;11(4):241-9.
Gharaibeh M and Abu-Saad H. Cultural validation of pediatric pain assessment tools: Jordanian perspective. Journal of Transcultural Nursing. 2002;13(1):12-8.
Abu-Saad H. The assessment of pain in children. Issues in Comprehensive Pediatric Nursing. 1981;5:327-35.
Yeh CH. Adaptation in children with cancer: Research with Roy’s model. Nursing Science Quarterly. 2001:14:141-8.
Jongudomkarn D, Aungsupakorn N and Camfield L. The meanings of pain: A qualitative study of the perspectives of children living with pain in north-eastern Thailand. Nursing and Health Sciences. 2006;8(3):156-63.
Abu-Saad H. Assessing children’s responses to pain. Pain. 1984;19:163-71.
Pfefferbaum B, Adams J and Aceves J. The influence of culture on pain in Anglo and Hispanic children with cancer. Journal of the American Academy of Child and Adolescent Psychiatry. 1990;29:642-7.
Al-Atiyyat NMH. Cultural diversity and cancer pain. Journal of Hospice and Palliative Nursing. 2009;11(3):154-64.
McDonald DD. Gender and ethnic stereotyping and narcotic analgesia administration. Research in Nursing and Health. 1994;17(1):45-9.
Finley GA, Kristjánsdóttir Ó and Forgeron PA. Cultural influences on the assessment of children's pain. Pain Research and Management. 2009;14(1):33-7.
Katz ER, Kellerman J and Siegel SE. Behavioral distress in children with cancer undergoing medical procedures: Developmental considerations. Journal of Consultation in Clinical Psychology. 1980;48:356-65.
Bournaki MC. Correlates of pain-related responses to venipunctures in schoolage children. Nursing Research. 1997;46:147-54.
McGrath PA and Hillier LM. Modifying the psychological factors that intensify children’s pain and prolong disability. In: N.L. Schechter, C.B. Berde, and M. Yaster (eds.), Pain in Infants, Children and Adolescents (2nd ed.), 2003, (pp. 85-104).
Zeltzer LK, Altman A, Cohen D, LeBaron S, Munksela EL and Schecter NL. Report of the subcommittee on the management of pain associated with procedures in children with cancer. Pediatrics, 1990;86:826-31.
Young MR and Fu VR. Influence of play and temperament on the young child's response to pain. Children's Health Care. 1988;16(3):209-15.
Lee LW and White-Traut RC. The role of temperament in pediatric pain response. Issues in Comprehensive Pediatric Nursing. 1996;19:49-63.
Bournaki MC. Correlates of pain-related responses to venipunctures in schoolage children. Nursing Research. 1997;46:147-54.
Schechter NL, Berstein BA, Beck A, Hart L and Scherzer L. Individual differences in children's response to pain: Role of temperament and parental characteristics. Pediatrics. 1991;87(2):171-7.
Ruddy-Wallace M. Temperament: a variable in children's pain management. Pediatric Nursing. 1989;15(2);118-21.
Helgadôttir HL and Wilson ME. Temperament and pain in 3- to 7-year-old children undergoing tonsillectomy. Journal of Pediatric Nursing. 2004;14(3):204-13.
Kleiber C, Suwanraj M, Dolan LA, Berg M and Kleese A. Pain-sensitive temperament and postoperative pain. Journal for Specialists in Pediatric Nursing. 2007;12(3):149-58.
Broome ME, Rehwaldt M and Fogg L. Relationships between cognitive behavioral techniques, temperament, observed distress, and pain reports in children and adolescents during lumbar puncture. Journal of Pediatric Nursing. 1998;13(1):48-54.
Jadad AR and Browman GP. The WHO analgesic ladder for cancer pain management. Stepping up the quality of its evaluation. JAMA. 1995;274(23):1870-3.
World Health Organization. Cancer Pain Relief and Palliative Care in Children. Geneva: WHO-IASP; 1998.
Liossi C. Management of paediatric procedure-related cancer pain. Pain Reviews. 1999;6:279-302.
Plummer K. Pain in pediatric oncology: A review of the literature. Anaesthesia and Intensive Care. 2012;40(3):547.
Weekes DP and Savedra MS. Adolescent cancer: Coping with treatment-related pain. Journal of Pediatric Nursing. 3, 1998;318-28.
Hockenberry MJ, McCarthy K, Taylor O, Scarberry M, Franklin Q, Louis CU and Torres L. Managing painful procedures in children with cancer. Journal of Pediatric Hematology-Oncology. 2011;33(2):119-27.
Chen E, Zeltzer LK, Craske MG and Katz ER. Children’s memories for painful cancer treatment procedures: implications for distress. Child Development. 2009;71(4):933-47.
Woodgate RL, Degner LF and Yanofsky R. A different perspective to approaching cancer symptoms in children. Journal of Pain and Symptom Management. 2003;26:800-17.
Dufresne A, Dugas MA, Samson Y, Barré P, Turcot L and Marc I. Do children undergoing cancer procedures under pharmacological sedation still report pain and anxiety? A preliminary study. Pain Medicine. 2010;11:215-23.
Kazak AE, Boyer BA, Brophy P and Himelstein B. Parental perceptions of procedure-related distress and family adaptation in childhood leukemia. Child Health Care. 1995;24:143-58.
Hedén L, Von Essen L, Ljungman G, Frykholm P and Ljungman G. Randomized interventions for needle procedures in children with cancer. European Journal of Cancer Care. 2009;18(4):358-63.
Jadad AR and Browman GP. The WHO analgesic ladder for cancer pain management. Stepping up the quality of its evaluation. JAMA. 1995;274(23):1870-3.
Zech DFJ, Grond S, Lynch J, Hertel D and Lehmann A. Validation of World Health Organization guidelines for cancer pain relief: A 10-year prospective study. Pain. 1995;63:65-76.
Caran EMM, Dias CD, Seber A, and Petrilli AS. Clinical aspects and treatment of pain in children and adolescents with cancer. Paediatric Blood Cancer. 2005;45:925-32.
Zernikow B, Smale H, Michel E, Hasan C, Jorch N and Andler W. Paediatric cancer pain management using the WHO analgesic ladder-results of a prospective analysis from 2265 treatment days during a quality improvement study. European Journal of Pain. 2006;10:587-95.
Mishra S, Bhatnagar S, Singh M, Gupta D, Jain R and Goyal GN. Pediatric cancer pain management at a regional cancer center: Implementation of WHO Analgesic Ladder. Middle East Journal of Anaesthesiology. 2009;20(2):239-44.
Geeta MG, Geetha P, Ajithkumar VT, Krishnakumar P, Suresh Kumar K and Mathews L. Management of pain in leukemic children using the WHO analgesic ladder. Indian Journal of Pediatrics. 2010;77:665-8.
Weisman SJ, Bernstein B and Schechter NL. Consequences of inadequate analgesia during painful procedures in children. Archives of Pediatric and Adolescent Medicine. 1998;152(2):147-9.
Blount RL, Piira T, Cohen LL and Cheng PS. Pediatric procedural pain. Behavior Modification. 2006;30(1):24-49.
Hedén L, Von Essen L, Ljungman G, Frykholm P and Ljungman G. Randomized interventions for needle procedures in children with cancer. European Journal of Cancer Care. 2009;18(4):358-63.
Lander JA, Weltman BJ and So SS. EMLA and amethocaine for reduction of children’s pain associated with needle insertion. Cochrane Database Systematic Reviews. 2006;19(3).
Harvey AJ and Morton NS. Management of procedural pain in children. Archives of Diseases in Childhood, Education and Practice. 2007;92(1):20-6.
McCarthy M, Glick R, Green J, Plummer K, Peters K, Johnsey L and Deluca C. Comfort First: An evaluation of a procedural pain management programme for children with cancer. Psycho-Oncology. 2012.
Ljungman G, Gordh T, Berg T, Sorensen S and Kreuger A. Pain in paediatric oncology: interviews with children, adolescents and their parents. Acta Paediatrica. 1999;88:623-30.
Halperin DL, Koren G, Attias D, Pellegrini E, Greenberg ML and Wyss M. Topical skin anesthesia for venous, subcutaneous drug reservoir and lumbar punctures in children. Pediatrics. 1989;84:281-4.
Kapelushnik J, Koren G, Solh H, Greenberg M and DeVeber L. Evaluating the efficacy of EMLA in alleviating pain associated with lumbar puncture: Comparison of open and double-blinded protocols in children. Pain. 1990;42:31-4.
Juarez-Gimenez JC, Oliveras M, Hidalgo E, Cabanas JM, Barroso C and Moraga FA, et al. Anesthetic efficacy of eutectic prilocaine–lidocaine cream in pediatric oncology patients undergoing lumbar puncture. Annals of Pharmacotherapy. 1996;30;1235-7.
Dufresne A, Dugas MA, Samson Y, Barré P, Turcot L and Marc I. Do children undergoing cancer procedures under pharmacological sedation still report pain and anxiety? A preliminary study. Pain Medicine. 2010;11:215-23.
Po’ C, Benini F, Sainati L, Farina MI, Cesaro S and Agosto C. The management of procedural pain at the Italian Centers of Pediatric Hematology–Oncology: Stateof- the-art and future directions. Support Care Cancer. 2012;20:2407-14.
Liossi C, White P and Hatira P. A randomized clinical trial of a brief hypnosis intervention to control venipuncture-related pain of paediatric cancer patients. Pain. 2009;142:255-63.
Gershon J, Zimand E, Pickering M, Rothbaum BO and Hodges L. A pilot and feasibility study of virtual reality as a distraction for children with cancer. Journal of the American Academy of Child and Adolescent Psychiatry. 2004;43:1243-9.
Gold JI, Kim SH, Kant AJ, Joseph MH and Rizzo AS. Effectiveness of virtual reality for pediatric pain distraction during I.V. placement. Cyberpsychology and Behavior. 2006;9:207-12.
Hawkins PJ, Liossi C, Ewart BW, Hatira P and Kosmidis VH. Hypnosis in the alleviation of procedure related pain and distress in pediatric oncology patients. Contemporary Hypnosis. 1998;15:199-207.
Kazak AE, Penati B, Boyer BA, Himelstein B, Brophy P and Waibel MK, et al. A randomized controlled prospective outcome study of a psychological and pharmacological intervention protocol for procedural distress in pediatric leukemia. Journal of Pediatric Psychology. 1996;21:615-31.
Iannalfi A, Bernini G, Caprilli S, Lippi A, Tucci F and Messeri A. Painful procedures in children with cancer: Comparison of moderate sedation and general anesthesia for lumbar puncture and bone marrow aspiration. Pediatric Blood Cancer. 2005;45(7);933-8.
Stinson J, Yamada J, Dickson A, Lamba J and Stevens B. Review of systematic reviews on acute procedural pain in children in the hospital setting. Pain Research Management. 2008;13(1):51-7.
Uman LS, Chambers CT, McGrath PJ, Kisely S, Matthews D and Hayton K. Assessing the quality of randomized controlled trials examining psychological interventions for pediatric procedural pain: Recommendations for quality improvement. Journal of Pediatric Psychology. 2010;35(7):693-703.
Rheingans J. A systematic review of nonpharmacologic adjunctive therapies for symptom management in children with cancer. Journal of Pediatric oncology Nursing. 2007;24(2):81-94.
Anghelescu D and Oakes L. Working toward better cancer pain management for children. Cancer Practice. 2002;10(Suppl 1):S52-S57.
Molassiotis A, and Cubbin D. ‘Thinking outside the box’: Complementary and alternative therapies use in paediatric oncology patients. European Journal of Oncology Nursing. 2004;8:50-60.
Landier W and Tse A. Use of complementary and alternative medical interventions for the management of procedure-related pain, anxiety, and distress in pediatric oncology: An integrative review. Journal of Pediatric Nursing. 2010;25:566-79.
National Center for Complementary and Alternative Medicine. Mind–Body medicine: An overview. [Citado: Febrero de 2014]. Disponible en: http://nccam.nih.gov/health/whatiscam/mind-body/mindbody.htm.
Richardson J, Smith JE, McCall G and Pilkington K. Hypnosis for procedurerelated pain and distress in pediatric cancer patients: A systematic review of effectiveness and methodology related to hypnosis interventions. Journal of Pain Symptom Management. 2006;31(1):70-84.
Liossi C and Hatira P. Clinical hypnosis in the alleviation of procedure-related pain in pediatric oncology patients. International Journal of Clinical and Experimental Hypnosis. 2003;51:4-28.
Katz ER, Kellerman J and Ellenberg L. Hypnosis in the reduction of acute pain and distress in children with cancer. Journal of Pediatric Psychology. 1987;12(3):379-94.
Contach P, Hockenberry M and Herman S. Self-hypnosis as antiemetic therapy in children receiving chemotherapy. Oncology Nursing Forum. 1985;12(4):41-6.
Hawkins PJ, Liossi C, Ewart BW, Hatira P, Kosmidis VH and Varvutsi M. Hypnotherapy for control of anticipatory nausea and vomiting in children with cancer: preliminary findings. Psycho-Oncology. 1995;4:101-6.
Zeltzer LK, Dolgin MJ, LeBaron S and LeBaron C. A randomized, controlled study of behavioral intervention for chemotherapy distress in children with cancer. Pediatrics. 1991;88:34-42.
Uman LS, Chambers CT, McGrath PJ and Kisely S. Psychological interventions for needle-related procedural pain in children and adolescents. Cochrane Database of Systematic Reviews. 2006;4.
Blount RL, Powers SW, Cotter MW, Swan S and Free K. Making the system work. Training pediatric oncology patients to cope and their parents to coach them during BMA/LP procedures. Behavior Modification. 1994;18:6-31.
Wint SS, Eshelman D, Steele J and Guzzetta C. Effects of distraction using virtual reality glasses during lumbar punctures in adolescents with cancer. Oncology Nursing Forum. 2002;29:8-15.
Gershon J, Zimand E, Pickering M, Rothbaum BO and Hodges L. A pilot and feasibility study of virtual reality as a distraction for children with cancer. Journal of the American Academy of Child and Adolescent Psychiatry. 2004;43:1243-9.
Gold JI, Kim SH, Kant AJ, Joseph MH and Rizzo AS. Effectiveness of virtual reality for pediatric pain distraction during I.V. placement. Cyberpsychology and Behavior. 2006;9:207-12.
Windich-Biermeier A, Sjoberg I, Dale JC, Eshelman D and Guzzetta CE. Effects of distraction on pain, fear, and distress during venous port access and venipuncture in children and adolescents with cancer. Journal of Pediatric Oncology Nursing. 2007;24:8-19.
Uman LS, Chambers CT, McGrath, PJ and Kisely S. Psychological interventions for needle-related procedural pain in children and adolescents. Cochrane Database of Systematic Reviews; 2006, 4.
Mercadante S. Cancer pain management in children. Palliative Medicine. 2004;18:654-62.
Nguyen TN, Nilsson S, Hellström AL and Bengston A. Music therapy to reduce pain and anxiety in children with cancer undergoing lumbar puncture: A randomised clinical trial. Journal of Paediatric Oncology Nursing. 2010;27(3):146-55.
Weekes DP, Kagan SH, James K and Seboni N. The phenomenon of hand holding as a coping strategy in adolescents experiencing treatment-related pain. Journal of Pediatric Oncology Nursing. 1993;10:19-25.
Ångström-Brännström C, Norberg A and Jansson L. Narratives of children with chronic illness about being comforted. Journal of Pediatric Nursing. 2008;23(4):310-6.
Landier W and Tse A. Use of complementary and alternative medical interventions for the management of procedure-related pain, anxiety, and distress in pediatric oncology: An integrative review. Journal of Pediatric Nursing. 2010;25:566-79.