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Palliative Medicine
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The role of oral controlled-release morphine for pain relief in children with cancer

Ann Goldman

Department of Haematology and Oncology, The Hospitals for Sick Children, Great Ormond Street, London

Angela Bowman

Pharmacy Department, The Hospitals for Sick Children, Great Ormond Street, London

Effective pain control is a key part of the care of children with cancer. We report our experience with controlled-release morphine tablets (MST Continus, NAPP) given as analgesia to 60 children who were terminally ill from a range of malignant diseases. MST was given over periods ranging from 1-165 days (median 14 days). We found that the appropriate initial dose was 1 mg/kg/dose for children whose pain was not controlled by mild analgesics or weak opioids. Maximum doses up to 41.6 mg/kg/dose were needed to maintain analgesia. Provision of a short-acting opioid is essential for breakthrough pain. The main side-effects were temporary drowsiness and constipation. Careful education of parents and health-care professionals in the correct use of MST is important. MST proved an effective and acceptable strong analgesic for children, particularly convenient for the terminally ill at home.

Key Words: analgesia • child • morphine • neoplasms • pain • palliative treatment

Palliative Medicine, Vol. 4, No. 4, 279-285 (1990)
DOI: 10.1177/026921639000400405
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