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Case Reports
. 2005 Mar;10(3):163-8.
doi: 10.1093/pch/10.3.163.

Three patients and their drugs: A parallel case paper on paediatric opiate use and withdrawal

Harold B Siden  1 , Kathleen Collin
Affiliations
Case Reports

Three patients and their drugs: A parallel case paper on paediatric opiate use and withdrawal

Harold B Siden et al. Paediatr Child Health. 2005 Mar.

Abstract
in English, French

Clinicians are increasingly aware of the important role that opioids play in the management of a variety of paediatric conditions. Frequently, clinicians encounter challenges in initiating opioid therapy and, then, in weaning paediatric patients off opioids. In the present article, three different cases (an infant and two adolescents) are used to illustrate why and how opiates may be used in paediatrics and how they can be discontinued. The presentations include neonatal abstinence syndrome, chronic headache and cystic fibrosis. The cases are meant to emphasize the distinctions rather than the similarities among the cases, which is why this is called a case parallel, rather than a case series. The article downplays the use of rigid rules in managing patients on opioids, and emphasizes a flexible and patient-centred approach.

Les cliniciens sont de plus en plus conscients du rôle important des opiacés dans la prise en charge de divers troubles pédiatriques. Souvent, les cliniciens affrontent des difficultés dans l’instauration du traitement aux opiacés, puis dans le sevrage des patients pédiatriques. Dans le présent article, trois cas différents (un nourrisson et deux adolescents) permettent d’illustrer les raisons pour lesquelles les opiacés peuvent être utilisés en pédiatrie et de quelle manière ainsi que la façon dont on peut les abandonner. Les présentations incluent un syndrome d’abstinence néonatale, des céphalées chroniques et une fibrose kystique. Les trois cas visent à faire ressortir les distinctions plutôt que les similarités. C’est pourquoi il est question de cas parallèles plutôt que d’une série de cas. L’article minimise l’importance de règles rigides dans la prise en charge des patients traités aux opiacés, mais met en relief l’importance d’une démarche flexible, centrée sur le patient.

Keywords: Adolescent; Child; Drug withdrawal; Neonatal abstinence syndrome; Opioids; Pain.

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Figures

Figure 1
Figure 1
Opioid weaning pattern for three patients
See this image and copyright information in PMC

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