• M Duval, F Legrand, A Faye, A Escot, S Vernois, P Rohrlich, C Wood, J Bockenmeyer, and E Vilmer.
• Service d'hémato-immunologie, hôpital Robert-Debré, Paris, France.
• Arch Pediatr. 2000 May 1; 7 (5): 474-80.

BackgroundPatient-controlled analgesia (PCA) has been shown to be superior to a continuous morphine infusion for the treatment of ongoing pain in children over five years of age. Nevertheless, prescription parameters such as the bolus dosage and the possible association of a continuous background infusion have not yet been standardized.Patients And MethodsThirty-three children, aged four to 17, hospitalized in a pediatric hematology ward, benefited from PCA with a standardized prescription: a bolus dosage of at least 25 mg/kg, without a background infusion. Morphine consumption, side effects and efficacy on pain relief were followed.ResultsMedian of mean morphine consumption was 0.32 mg.kg-1.d-1. Median of maximal consumption was 0.58 mg.kg-1.d-1. Mean duration was nine days. No important side effects were noted, except in two patients. They presented prolonged constipation and a poor quality of nocturnal sleep, but they also had a major depressive syndrome persisting after resolution of pain. Efficacy was comparable to a continuous intravenous infusion, and nocturnal sleep was of good quality for 31 children.ConclusionThis standardized technique of PCA can be used extensively in children over five years of age. It can be used as a reference for further studies.

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