Analgesic Effectiveness by Pain Intensity and Location in Pediatric Oncology Patients

Background: Cancer in children and adolescents (ages 0 to 19) is frequently associated with pain, which is one of the most common and distressing symptoms reported by pa-tients. Effective pain management remains a major concern for healthcare teams. Despite the existence of national and international pain management protocols since the mid-1980s, challenges persist in the assessment, treatment, and follow-up of pediatric pa-tients. There is a lack of studies evaluating the most appropriate type and dosage of anal-gesics to achieve adequate pain control in pediatric oncology settings. Objective: To assess the effectiveness of selected analgesics based on pain intensity and anatomical location in pediatric cancer patients. Methods: This is a pharmacoepidemiologic study carried out in a pediatric oncology hospital, with inclusion of patients aged 0 to 17 years old with cancer and using analgesic drug. Information regarding cancer diagnosis, hospitalization diag-nosis, analgesic scale and pain intensity before and after drug administration and pain site were collected from medical records. Results: A total of 1,465 episodes of pain from 335 patients were included, most of them diagnosed with leukemia (30.1%). We included 576 episodes of pain treated with dipyrone or morphine that occurred 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 wild to moderate, dipyrone was the most 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 un-bearable, morphine was the most used drug: 79 (64.7%) in the abdomen and 36 (60.6%) in the lower limbs; except in the head (17 episodes of pain, 35.4%). Conclusions: The use of dipyrone and morphine, guided by pain intensities and locations, demonstrated effective-ness. These findings support the tailored use of analgesics according to pain characteris-tics to optimize symptom control in pediatric oncology patients.