Ruggiero, A., Coccia, P., Arena, R., Maurizi, P., Battista, A., Ridola, V., . . . Riccardi, R. (2013). Efficacy and safety of transdermal buprenorphine in the management of children with cancer-related pain. Pediatric Blood & Cancer, 60, 433–437.doi: 10.1002/pbc.24332
To investigate the safety and efficacy of transdermal buprenorphine in the treatment of chronic cancer pain in children
Patients receiving other analgesics were transitioned to transdermal buprenorphine. The initial dose was 8.75–35 mcg/hour, depending on body weight. Patches were changed every three days. If needed, the dose could be titrated by means of a standard scheme. Study evaluations were done on days 4, 7, 14, 30, 44, and 60. Rescue medication, tramadol 1–2 mg/kg for breakthrough pain, was allowed as needed but not more than twice daily. School-age children self-reported study measures. Parents reported measures related to younger children.
Clinical application: pediatrics
Prospective observational study
Transdermal buprenorphine was effective at treating chronic cancer-related pain in pediatric patients. Patients tolerated the drug well.
Findings suggest that pediatric patients can safely use transdermal buprenorphine and that it is effective at treating the pain of the specified patients. Nurses should be aware that these findings resulted from a study with a very small sample; the findings may not reflect actual frequency of adverse events. Pediatric patients should be closely monitored for adverse events. The side effects of transdermal buprenorphine in children are the effects typical of opioids; care should include a prophylactic approach to side effect management.