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

Abstract

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.