Abstract
A 7-year-old patient with neuroblastoma complaining of intractable back and abdominal pain was successfully managed with intravenous morphine using a patient-controlled analgesia (PCA) device. Initially, his pain was controlled with 80mg •d-1 of oral morphine. However, the breakthrough nature of the pain required the introduction of intravenous PCA, where a bolus button was controlled by his parents according to his request. The maximum dose of morphine reached up to 960mg •d-1 (2.2mg• kg-1 •h-1), but no significant side effects were observed. On the other hand, administration of an intravenous infusion of ketamine was effective for shooting pain which was not controlled with a morphine infusion. Among the key factors to achieve this well-controlled status were an accuracy of pain assessment, early recognition of side effects, and good communication between family members and medical caregivers, so we should emphasize the critical role of family education in pediatric home palliative care.
