Medical Terms

acetaminophen (e.g. Tylenol®): a drug used to control mild pain and fever. It comes in a liquid, chewable tablets, or caplets.

addiction: drug-seeking behaviour that occurs after the drug is no longer needed. Contrary to popular belief, this is not a problem if drugs are given for pain.

amitriptyline (e.g. Elavil®): this drug is most widely used for depression. When used in smaller doses, it is often useful for pain, especially pain related to nerve damage.

analgesic: a drug that reduces pain, a pain killer.

Aspirin®: a mild analgesic rarely used with children.

Broviac®: a type of external central line.

carbamazepine (e.g. Tegretol®): an anti-epileptic or anti-convulsant drug that is often used to treat pain due to nerve damage.

catheter: a tube which is inserted into a body cavity such as the bladder or into a vein. It is used to add or remove things from the body.

central venous access line (CVL): a long catheter that is inserted into a large vein and can stay in place for an extended period of time. It is used to give drugs or to take blood samples. External lines (e.g. Broviac®) are outside the skin while internal lines (e.g. Port-a-Cath®) are under the skin.

codeine: a mild opioid analgesic that is useful in mild or moderate pain. It may be combined with acetaminophen.

conscious sedation: an anaesthetist (or other specially trained doctor) uses powerful drugs to abolish pain, while the child is still awake. The child has no memory of the procedure.

diazepam (e.g. Valium®): a minor tranquillizer often used to reduce anxiety.

deep sedation: an anaesthetist (or other specially trained doctor) uses powerful drugs to abolish pain. The child is asleep for a few minutes.

dependence: If an opioid drug like morphine is taken for more than a few days, and stopped suddenly, the child will feel anxious, irritable, or sick. This is because the body has become used to, or dependent on, the drug. If the drug is reduced gradually these problems do not occur. This is not the same as addiction, which almost never occurs in cancer pain treatment.

EMLA®: a mixture of two local anaesthetics, lidocaine and prilocaine. When combined in a cream these drugs are able to numb the skin and prevent or reduce pain from needles and other minor procedures.

epidural: An anaesthetic drug (like lidocaine or bupivicaine) or an opioid (like fentanyl or morphine) is put into a part of the spine near the spinal cord to cause numbness or to control pain in a speci fic part of the body.

fentanyl (Sublimaze®): a strong, short-acting opioid drug used in general anaesthesia and deep sedation.

general anaesthetic: an anaesthetic that affects the whole body. It may be given by mask or by needle to cause the child to go to "sleep" for an operation or other procedure. A specially-trained doctor (an anaesthetist or anesthesiologist) administers the anaesthetic and stays with the child the whole time he or she is asleep.

hydromorphone (e.g. Dilaudid®): a strong opioid that is used in the same way as morphine.

ibuprofen (e.g. Advil®, Motrin®, Nuprin®): a non-steroidal anti-inflammatory drug (NSAID) used for mild or moderate pain.

IM (intramuscular): IM injections are usually given in the leg or buttock and are used for some chemotherapy treatments. IM injections should not be used for pain control.

IV (intravenous): literally, into the vein. IV's are used to give medication or liquids. Intravenous lines can be kept in for days or longer.

ketamine (Ketalar®): a short acting anaesthetic that is used in conscious or deep sedation.

lidocaine (e.g. Xylocaine®): a local anaesthetic that is used to make the skin numb. Sometimes it is put under the skin by a small needle. It is also one of the drugs in EMLA®.

local anaesthetic: a drug that numbs a speci fic area of the body. It may be given as a cream (EMLA®) or by needle. The anaesthetic is placed on or in a speci fic area of the body to cause a loss of feeling around that area only.

lorazepam (e.g. Ativan®): a minor tranquillizer used to reduce anxiety.

meperidine (e.g. Demerol®): an opioid that is widely used for post-operative pain. It is not advised for long term use because the by-products of this drug may be toxic.

midazolam (Versed®): a very short-acting sedative drug used in conscious sedation.

morphine: an opioid analgesic drug widely used in the management of severe pain. It is safe, has many uses, and is inexpensive. Morphine can be given intravenously, subcutaneously, or by mouth. Its effects usually last 3 or 4 hours. Sustained-release pills (e.g. MS-Contin®) that last 8 to 12 hours are available. In some areas, methadone is used instead of sustained-release morphine.

naproxen (e.g. Naprosyn®): a non-steroidal anti-inflammatory drug used for mild or moderate pain.

narcotics: (see opioids)

nitrous oxide: "Laughing gas" can sometimes be used for painful procedures. It is available in pre- mixed canisters or can be given by means of an anaesthesia machine.

NPO: or "nil per os", means nothing should be given by mouth.

NSAID: Non steroidal anti-inflammatory drugs (like naproxen or ibuprofen) are often used in treatment of arthritis and are particularly useful for some types of bone pain.

opioids: all drugs that are similar to morphine. Commonly used opioids include meperidine, fentanyl, morphine, codeine, and hydromorphone.

oxygen saturation: the amount of oxygen in the blood. This is a good measure of how well a child is breathing.

PCA (Patient Controlled Analgesia): a computer-controlled infusion pump that allows the patient to control the amount of pain medication he or she receives.

PO: or "per os" means the drug is taken by mouth. Port-a-Cath®: a type of internal central venous access line.

Pulse oximeter: a machine that measures the oxygen saturation (see above). A pulse oximeter should be used to check the child during and after deep sedation or conscious sedation.

PR: or "per rectum" means that the drug is taken as a suppository or gel placed in the rectum.

prilocaine: a local anaesthetic that is one of the drugs in EMLA®.

PRN: or "pro re nata" means "as needed". Unfortunately, that often means that pain medication is not given until after the pain recurs.

Q4H: every four hours. regional anaesthetic block: the injection of a drug into a nerve or the spinal column to relieve pain.

respiratory depression: a decrease in the number of breaths and the depth of breathing. It can be a side effect of strong analgesics such as morphine.

S/C (subcutaneous, pronounced "sub Q"): "under the skin".

tolerance: Children may become tolerant to morphine or another opioid and may require a larger dose after they have been taking the drug for a prolonged time