Practical pain therapy in pediatric oncology

In paediatric oncology,optimal pain control is still a challenge. A structu red pain history and the regular scoring of pain intensity using age-adapte d measuring tools are hallmarks of optimal pain control. Psychological meas ures are as important as drug therapy in prophylaxis or control of pain, es pecially when performing invasive procedures. Pain control is oriented on t he WHO analgesic ladder. On no account the paediatric patient should have t o climb up the 'analgesic ladder' - strong pain requires the primary use of strong drugs. Opioids should be given by the oral route and by the clock - short acting opioids should be used to treat break-through pain. Alternati ves are IV infusion and patient-controlled analgesia. Constipation is the a dverse effect most often seen with (oral) opioid therapy. Adverse effects s hould be anticipated, and prophylactic treatment should be given consistent ly. The assistance of paediatric nurses is of utmost importance in paediatr ic pain control. Nurses deliver the basis for rational and effective pain c ontrol by scoring pain intensity and documenting drug administration as wel l as adverse effects. The nurses' task is also to prepare the patient for a nd monitor the patient during painful procedures. It is the responsibility of both nurse and doctor to guarantee emergency intervention during sedatio n whenever needed. In our paper we comment on drug selection and dosage, pa in measurement tools, and documentation tools for the purpose of pain contr ol. Those tools may be easily integrated into daily routine.