Cancer Pain Management: Route of Administration of Opioid Analgesics

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Anesthesia in Children

Cancer Pain Management

Pediatrics Anesthesia

Bariatric Surgery for the Adolescence

Congenital Myopathies & Anesthesia

Anesthesia and Associated Diseases

Chronic Pain in Children

Anesthesia for Pediatric Laparoscopy

Alternative Therapies for Pain Management

Cancer Pain Management

Pediatric Anesthesia

Clinical Tools

Clinical Vignettes

Diseases & Conditions

Drugs Interaction Calculator

Podcasts

Patient Management Online

Diagnostic Dilemma

Question of the Day

Diagnostic Aid

VACCINE REMINDER

"Get the Vaccine Schedule for your child."

Ask Queries

SPECIALIST ANSWERS

FIND DIAGNOSIS

Today's Poll

Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?

No, it should be used only after drug sensitivity report

Yes, under guidance of an infectious disease expert

Vote

Results

CANCER PAIN MANAGEMENT

Related topics

Cancer Pain and Analgesic Ladder Approach

Newer Techniques of Drug Delivery

PCA and Transcranial Electrostimulation

RF Nerve Blockade and TENS

Dr Sunita Goel
Lecturer in Anaesthesiology
BJ Wadia Children's Hospital

Routes of administration:

The oral route for opioid delivery is effective, economical and acceptable to most patients. It is preferred for chronic opioid therapy. During the course of a medical illness, however a substantial proportion of patients require an alternative route, at least for a period of time. A large number of alternative route are available and in the absence of comparative trial, the selection of one or another is based on clinical judgement and experience.

Routes of administration: (Table 2)

Routes of administration

Route	Comment
Oral	Preferred in cancer patients
Sublingual	Buprenorphine effective, efficacy of highly lipid soluble drugs, such as fentanyl is likely but no studies & very little clinical experience. Efficacy of morphine controversial
Rectal	Available for morphine, oxymorphine & hydromorphone. Methadone has been compounded and used successfully.
Transdermal	Available for fentanyl. Dosing interval is 2-3 days. Empirical indications include difficulty with swallowing or GIT absorption, desire for fentanyl trial, compliance problems with anal dosing, possibly severe constipation and possibly desire to offer an alternative that the patient perceives may improve quality & life
Oral transmucosal	Formulations using fentanyl
Subcutaneous: Repetitive bolus Continuous infusion Continuous infusion with PCA	Ambulatory infusion pumps can provide continuous infusion with any parenteral opioid formulations. Clearest indication is inability to tolerate oral route .
Intravenous: Repetitive bolus Continuous infusion Continuous infusion with PCA	Continuous infusion possible
Epidural: Repetitive bolus Continuous infusion using percutaneous or unplanted system	Clearest indication is pain below the mid-chest & Rx limiting Side effects from systemic opioids. Often co-administered with local anesthetics

Next : Route of Administration of Opioid(Contd.)

Mail To Your Friend

Print This Article

PEDIATRIC ANESTHESIA : EXPERTISE VIEWS

Precautions for Child Under General Anesthesia for Autism

TOP SEARCH TERMS

Bariatric Surgical treatment

Congenital Myopathies

Choice Of Anaesthesia

Anesthesia general principles

Chronic pain disorders

Laproscopy

Paint Managment Therapies

Cancer pain

Adjuvant analgesics

Anesthesia Methods

Diseases & Conditions

Pediatric Oncall Journal

Pediatric Conferences

Ped Tools

Adverse Drug Reactions

Head circuferences Calculator

Mid parental height Calculator

Body surface area Calculator

BMR Calculator

Temperature Calculator

Pediatric oncall book store

Partner Sites

Infection in Children

Pedcall

Medical ADRIS

Vaccine Reminder

Pediatric Oncall Journal

Educational Section

Disclaimer:

The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.

Sitemap For Doctor

Sitemap For Parent

Sitemap For Kids