Utilisation de la morphine orale pour les douleurs post-traumatiques de l'enfant

Wille, Clara; Bocquet, N.; Cojocaru, B; Leis, Aleda; Chéron, G.

doi:10.1016/j.arcped.2004.07.021

Cited by 17 publications

(3 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The PRISMA Study Flow Diagram ( Figure 1 ) shows the flow of studies for this review. Of the 34 studies of potential relevance identified, 26 were excluded: nine were not randomized controlled trials [ 16 , 19 – 26 ]; one was an adult-only study [ 27 ]; one included only two children over a total of 67 patients with no specific pediatric data available [ 28 ]; one was concerned with fracture reduction [ 29 ]; one was conducted with healthy volunteers [ 30 ]; six had data collected at the participant's home after discharge from the ED [ 31 – 36 ]. The remaining seven studies were excluded despite adequate methodology, because we were unable to obtain the raw data necessary to calculate their risk ratio, despite multiple efforts to obtain this information from the authors [ 37 – 43 ].…”

Section: Resultsmentioning

confidence: 99%

Pain Management of Pediatric Musculoskeletal Injury in the Emergency Department: A Systematic Review

May

Ali

Khadra

et al. 2016

Pain Research and Management

View full text Add to dashboard Cite

Background. Pain management for children with musculoskeletal injuries is suboptimal and, in the absence of clear evidence-based guidelines, varies significantly. Objective. To systematically review the most effective pain management for children presenting to the emergency department with musculoskeletal injuries. Methods. Electronic databases were searched systematically for randomized controlled trials of pharmacological and nonpharmacological interventions for children aged 0–18 years, with musculoskeletal injury, in the emergency department. The primary outcome was the risk ratio for successful reduction in pain scores. Results. Of 34 studies reviewed, 8 met inclusion criteria and provided data on 1169 children from 3 to 18 years old. Analgesics used greatly varied, making comparisons difficult. Only two studies compared the same analgesics with similar routes of administration. Two serious adverse events occurred without fatalities. All studies showed similar pain reduction between groups except one study that favoured ibuprofen when compared to acetaminophen. Conclusions. Due to heterogeneity of medications and routes of administration in the articles reviewed, an optimal analgesic cannot be recommended for all pain categories. Larger trials are required for further evaluation of analgesics, especially trials combining a nonopioid with an opioid agent or with a nonpharmacological intervention.

show abstract

Section: Resultsmentioning

confidence: 99%

Pain Management of Pediatric Musculoskeletal Injury in the Emergency Department: A Systematic Review

May

Ali

Khadra

et al. 2016

Pain Research and Management

View full text Add to dashboard Cite

show abstract

“…However, studies using oral morphine to treat acute pain in children are scarce. Oral morphine 0.5 mg/kg was found to decrease pain by 80 % in children with limb fractures [47]. The authors of a randomized controlled trial (RCT) investigating the efficacy of oral morphine 0.5 mg/kg alone compared with the same dose of oral morphine combined with sublingual midazolam 0.2 mg/kg in children with displaced fracture described a similar decrease of pain in both groups [48].…”

Section: Oral Opioid Analgesics For Non-responders or For Moderate Painmentioning

confidence: 94%

Managing Pediatric Pain in the Emergency Department

Bailey

Trottier

2016

Pediatr Drugs

View full text Add to dashboard Cite

Far more attention is now given to pain management in children in the emergency department (ED). When a child arrives, pain must be recognized and evaluated using a pain scale that is appropriate to the child's development and regularly assessed to determine whether the pain intervention was effective. At triage, both analgesics and non-pharmacological strategies, such as distraction, immobilization, and dressing should be started. For mild pain, oral ibuprofen can be administered if the child has not received it at home, whereas ibuprofen and paracetamol are suitable for moderate pain. For patients who still require pain relief, oral opioids could be considered; however, many EDs have now replaced this with intranasal fentanyl, which allows faster onset of pain relief and can be administered on arrival pending either intravenous access or definitive care. Intravenous opioids are often required for severe pain, and paracetamol or ibuprofen can still be considered for their likely opioid-sparing effects. Specific treatment should be used for patients with migraine. In children requiring intravenous access or venipuncture, non-pharmacological and pharmacological strategies to decrease pain and anxiety associated with needle punctures are mandatory. These strategies can also be used for laceration repairs and other painful procedures. Despite the gaps in knowledge, pain should be treated with the most up-to-date evidence in children seen in EDs.

show abstract

“…A study focusing on morphine use in the postoperative period in pediatric patients did not clarify if there are differences in its adverse effects profile compared to other intravenous opioid drugs [30]. In a prospective study, oral morphine had reduced pain by 80% in children with limb fractures [31]. Also, a randomized controlled trial compared oral morphine versus oral ibuprofen in children with uncomplicated limb fractures, but did not find any differences in pain relief; however, the group treated with oral morphine experienced significantly more adverse effects [32].…”

Section: Morphinementioning

confidence: 99%

Pain Evaluation and Treatment in Children: A Practical Approach

et al. 2023

View full text Add to dashboard Cite

Pain is the most common complaint reported by children who access the emergency departments, but despite its frequency and the availability of many international guidelines, it often remains underreported and undertreated. Recently, the American Academy of Pediatrics and the American Pain Society have reiterated the importance of a multidisciplinary approach in order to eliminate pain in children. In all pediatric settings, an adequate assessment is the initial stage in a proper clinical approach to pain, especially in the emergency departments; therefore, an increasing number of age-related tools have been validated. A wide range of analgesic agents are currently available for pain management, and they should be tailored according to the patient’s age, the drug’s pharmacokinetics and the intensity of pain. In order to facilitate the choice of the appropriate drug, a treatment algorithm based on a ladder approach can be used. Moreover, non-pharmacological techniques should be considered to alleviate anxiety and distress in pediatric age. This review aims to offer a simple but intuitive description of the best strategies for pain relief in children, starting with the prompt recognition and quantification of pain through adequate assessment scales, and following with the identification of the most appropriate therapeutic choice among the ones available for pediatric age.

show abstract

Utilisation de la morphine orale pour les douleurs post-traumatiques de l'enfant

Cited by 17 publications

References 24 publications

Pain Management of Pediatric Musculoskeletal Injury in the Emergency Department: A Systematic Review

Pain Management of Pediatric Musculoskeletal Injury in the Emergency Department: A Systematic Review

Managing Pediatric Pain in the Emergency Department

Pain Evaluation and Treatment in Children: A Practical Approach

Contact Info

Product

Resources

About