# Association of analgesic pharmacological effect with pain site in pediatric oncology patients

## TL;DR

This study examines how the effectiveness of pain medications in children with cancer varies depending on the pain's intensity and location.

## Contribution

The study provides insights into the tailored use of analgesics based on pain intensity and anatomical location in pediatric oncology.

## Key findings

- Dipyrone was more commonly used for mild to moderate pain in the abdomen, head, and lower limbs.
- Morphine was predominantly used for severe to unbearable pain in the abdomen and lower limbs, but less so for head pain.
- Both drugs showed pharmacological effectiveness across all patient subgroups.

## Abstract

Cancer in children and adolescents is frequently associated with pain, which is one of the most common and distressing symptoms reported by patients. Effective pain management remains a major concern for healthcare teams. Despite the availability of national and international pain management protocols since the mid-1980s, challenges persist in the assessment, treatment, and follow-up of pediatric patients. There is a lack of studies evaluating the most appropriate type and dosage of analgesics to achieve adequate pain control in pediatric oncology settings.

The objective of this work was to assess the effectiveness of selected analgesics based on pain intensity and anatomical location in pediatric cancer patients.

This pharmacoepidemiological study was conducted in a pediatric oncology hospital and included patients aged between 0 and 17 years with cancer who received analgesic drugs. Information regarding cancer diagnosis, hospitalization diagnosis, analgesic scale, pain intensity before and after drug administration, and pain site were collected from medical records.

A total of 1,465 episodes of pain from 335 patients were analyzed, most of them in patients diagnosed with leukemia (30.1%). We included 576 episodes of pain treated with dipyrone or morphine, occurring in the abdomen (n = 283), head (n = 155), and lower limbs (n = 138). The final pain scores indicated pharmacological effectiveness in all patient subgroups. When pain was mild to moderate, dipyrone was the most commonly used drug: 105 (65.2%) episodes of pain that occurred in the abdomen, 93 (86.9%) in the head, and 50 (64.1%) in the lower limbs. However, when the pain was severe to unbearable, morphine was the most commonly used drug: 79 (64.7%) episodes in the abdomen and 36 (60.6%) in the lower limbs, except when the pain occurred in the head (17 episodes of pain, 35.4%).

The use of dipyrone and morphine, guided by pain intensities and locations, demonstrated effectiveness. These findings support the tailored use of analgesics according to pain characteristics to optimize symptom control in pediatric oncology patients.