Page 165 WHO - Guidelines on the pharmacological treatment of persisting pain in children with medical illness

P breakthrough 21, 46, 94
pain choice of opioid 46, 147
clinical question 93–94
abdominal 23, 114 definition 8, 46
oxycodone versus placebo, GRADE table 114 distinction from end of dose and incident
acute 20 pain 46, 94, 147
anatomic origin of ~ stimulus 20 immediate-release morphine versus other
assessment 27–35 opioids, routes of administration, clinical
ability to indicate pain verbally 29 question 93
challenges 35 rescue doses 40
education health-care providers 35 calculation 46, 64, 75
in children with severe malnutrition 30 patient-controlled analgesia (PCA) 46
in preverbal children 30 route of administration 46, 147
in young children 29 burns 13
initial 27 cancer 13, 24–25
integration in clinical care 27 oral morphine, GRADE table 116
observation of behaviour 29 use of transdermal fentanyl, GRADE table 121
role of parents and caregivers 35 cancer treatment 13, 24–25
assessment tools 30–33 causes and types of ~ in children with
definition 9 HIV/AIDS 23–24
for self-report 31–32 chest 24
guidance for use 33 chronic 20
pain intensity scales 31 chronic complex 13
pain intensity scales, self-reporting 31–32 classification systems 18–22
0-10 Numerical Rating Scale 32 anatomical 18, 21–22
Faces-Pain Scale - Revised 31 duration based 18, 20–21
Oucher Photographic 32 acute 20
Pieces of Hurt/Poker Chip tool 31 breakthrough 21
Visual Analogue Scale (VAS) 32 chronic 20
psychometrically validated 31 end of dose 21
selection criteria 33 episodic or recurrent 21
use of 31 incident, or pain due to movement 21
behaviour 29–33 long-term 21
behavioural indicators persisting 21
abnormal posturing 30 etiological 18, 21
activities, restriction of physical and social ~ 34 pathophysiological 18–20
acute pain 29–30 neuropathic 18, 22
anger 30, 35 nociceptive 18, 22
appetite changes 30 somatic 18, 22
body movement, posture 30 visceral 18, 22
chronic pain 30 definition 17
sleep disruption 34, 35 dimensions 17
coping skills, older children 35 distinction between types 46, 147
crying 30 ear 24
emotional disturbances 35 end of dose 21, 46
facial expression 30 definition 8
fear of being moved 30 epidural morphine versus fentanyl or
groaning 30 hydromorphone, GRADE table 110
inability to be consoled 30 episodic or recurrent 21
interest in surroundings, lack of 30 extremity injury 109
irritability, increased 30 generalized 24
low mood 30, 34 headache 23
pain denial 30 idiopathic 20
preverbal children 30 definition 8
school performance, poor 30, 35 inability to establish an underlying cause 20
severe malnutrition 30 incident 21, 46
bone pain 50–51 definition 8
bisphosphonates as adjuvants in ~ 50, 95, 147 intensity
intranasal fentanyl versus intravenous definition 9
morphine, GRADE table in pain from bone intermittent 40
fractures 108 long-term 21

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