Journal of palliative medicine
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The American Academy of Pediatrics recommends that pediatricians become knowledgeable in and comfortable with providing palliative care. ⋯ Efforts to improve education in pediatric palliative care are needed. A palliative care team could facilitate palliative care education through engaging trainees in "real-life" interactions. The role of physicians in providing spiritual support and the need for educating physicians in obtaining emotional support for themselves merit further investigation.
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There are relatively well-defined and preferred therapies for neuropathic pain including newer generation anticonvulsants (such as gabapentin), TCAs, and opioids in select patients. In patients with ongoing pain despite treatment with these agents, or who are intolerant to them, venlafaxine or duloxetine may be helpful. There are no comparative studies between nontricyclics for neuropathic pain, thus an agent should be selected based on its side effect profile, cost, and familiarity with use.