Pharmacological interventions for pain in children and adolescents with life-limiting conditions

Beecham, Emma; Candy, Bridget; Howard, Richard; McCulloch, Renée; Laddie, Jo; Rees, Henrietta; Vickerstaff, Victoria; Bluebond-Langner, Myra; Jones, Louise

doi:10.1002/14651858.cd010750.pub2

Cited by 20 publications

(27 citation statements)

References 79 publications

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“…Quality assessment of level I to level III studies found ( n =number of studies): strong ( n =2), moderate ( n =12), and weak ( n =8) quality. Adequate conduct and report of appropriate statistical evaluation including power evaluations was described in nine studies . Suitable methods for controlling confounding variables and limiting potential biases were not reported in any studies.…”

Section: Resultsmentioning

confidence: 99%

Management of pain in children and adolescents with cerebral palsy: a systematic review

Ostojic

Paget

Morrow

2018

Develop Med Child Neuro

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ABBREVIATIONS BoNT-A Intramuscular botulinum toxin-A VAS Visual analogue scale ITB Intrathecal baclofen AIM To determine the efficacy of interventions for the management of pain in children and adolescents with cerebral palsy (CP). METHOD Electronic databases were searched from the earliest date possible to April 2018 using a mixture of subject headings and free text. Inclusion criteria comprised of studies with (1) diagnosis of CP, (2) under the age of 18 years, (3) intervention for the management of pain, (4) outcome measure of pain, and (5) studies published in English-language peerreviewed journals. RESULTS Fifty-seven studies met the eligibility criteria. Pain related to (n=number of studies): hypertonia (n=17), spastic hip disease (n=13), procedures for the management of CP (n=7), postoperative (n=18), and other (n=2). Most of the studies were of level III to level V evidence.

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Section: Resultsmentioning

confidence: 99%

Management of pain in children and adolescents with cerebral palsy: a systematic review

Ostojic

Paget

Morrow

2018

Develop Med Child Neuro

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“…For example, in a child with combined dystonia and epilepsy, may benefit from using one medication that addresses both symptoms such as gabapentin, instead of two medications targeting the symptoms individually. Additionally, botulinum toxin [187], intrathecal baclofen [179,180], and gabapentin [179] appear to reduce pain (yellow light, weak positive), which may further support the clinical decision to trial these agents, despite this not being the primary mechanism of these agents, as the multiple benefits may make them an acceptable intervention to children and parents. Deep brain stimulation appeared promising for children with dystonia that caused pain and severely limited daily participation and more research is warranted [177,198].…”

Section: Tone Managementmentioning

confidence: 91%

State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy

Novak

Morgan

Fahey

et al. 2020

Curr Neurol Neurosci Rep

526

524

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Purpose of Review Cerebral palsy is the most common physical disability of childhood, but the rate is falling, and severity is lessening. We conducted a systematic overview of best available evidence (2012-2019), appraising evidence using GRADE and the Evidence Alert Traffic Light System and then aggregated the new findings with our previous 2013 findings. This article summarizes the best available evidence interventions for preventing and managing cerebral palsy in 2019. Recent Findings Effective prevention strategies include antenatal corticosteroids, magnesium sulfate, caffeine, and neonatal hypothermia. Effective allied health interventions include acceptance and commitment therapy, action observations, bimanual training, casting, constraint-induced movement therapy, environmental enrichment, fitness training, goal-directed training, hippotherapy, home programs, literacy interventions, mobility training, oral sensorimotor, oral sensorimotor plus electrical stimulation, pressure care, stepping stones triple P, strength training, task-specific training, treadmill training, partial body weight support treadmill training, and weight-bearing. Effective medical and surgical interventions include anti-convulsants, bisphosphonates, botulinum toxin, botulinum toxin plus occupational therapy, botulinum toxin plus casting, diazepam, dentistry, hip surveillance, intrathecal baclofen, scoliosis correction, selective dorsal rhizotomy, and umbilical cord blood cell therapy. Summary We have provided guidance about what works and what does not to inform decision-making, and highlighted areas for more research.

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“…Priorities for CPC research generally are varied, with research in HICs focusing on issues such as service evaluation,50–52 decision making,46 53 the impact of educational programmes,54 55 telehealth,56 57 preferred place of death,58 resource utilisation and costs,59 60 pain management,40 61 perinatal palliative care,62 screening for palliative care,63 64 and quality-of-life measures 65…”

Section: Status Of the Sciencementioning

confidence: 99%

Children's palliative care in low- and middle-income countries

Downing

Powell²,

Marston

et al. 2015

Arch Dis Child

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One-third of the global population is aged under 20 years. For children with life-limiting conditions, palliative care services are required. However, despite 80% of global need occurring in low- and middle-income countries (LMICs), the majority of children's palliative care (CPC) is provided in high-income countries. This paper reviews the status of CPC services in LMICs--highlighting examples of best practice among service models in Malawi, Indonesia and Belarus--before reviewing the status of the extant research in this field. It concludes that while much has been achieved in palliative care for adults, less attention has been devoted to the education, clinical practice, funding and research needed to ensure children and young people receive the palliative care they need.

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Pharmacological interventions for pain in children and adolescents with life-limiting conditions

Cited by 20 publications

References 79 publications

Management of pain in children and adolescents with cerebral palsy: a systematic review

Management of pain in children and adolescents with cerebral palsy: a systematic review

State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy

Children's palliative care in low- and middle-income countries

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