JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice)
Vol 16, No 2

Effectiveness of Opioids-Adjuvant Analgesics Combinations for Pediatric Cancer Pain: A Systematic Review

Ulfa Filliana (Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Wahid Hasyim, Semarang, Central Java)
Susi Ari Kristina (Department of Pharmaceutics, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta)
Bekti Meilani Nurcahya (Division of Clinical Pharmacy in Pediatric, RSUP Dr. Kariadi Semarang, Central Java)



Article Info

Publish Date
30 Jun 2026

Abstract

Background: The pediatric cancer was reported that they got worst pain and 40% weren’t managed well. The impact of untreated cancer pain is low quality of life and poor pain experienced. Therefore, it is important to know the best analgesic for improving the clinical outcome of pain.Objectives: This study aims to determine the effectiveness of using opioid combined with adjuvant analgesics based on WHO analgesic ladder in pediatric cancer pain.Methods: PubMed and Science Direct were searched for randomized controlled trials and retrospective studies by the keyword’s “opioid”, “adjuvant analgesic”, “pediatric”, “cancer” within 2014-2024. The primary outcome was using Faces Pain Scale, or visual analog scale (VAS), or numerical rating scale (NRS).Results: A result of 556 studies were reviewed. After further inspection of collected studies, only 5 studies achieved all inclusion criteria. The final studies consist of two prospective studies with randomized trial and three retrospective studies. Combination gabapentin or pregabalin as adjuvant analgesic with opioids was better reduced pain intensity and less adverse events than other combinations.Conclusion: This study supports the increased effectiveness of analgesic opioid combined with adjuvant analgesics, compared with single opioid, in the treatment of pediatric cancer pain. Further study inspires researchers to conduct studies using the randomized trial method and continue meta-analysis study especially in pediatric population and developing countries.

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Journal Info

Abbrev

jmpf

Publisher

Subject

Health Professions Medicine & Pharmacology Public Health

Description

JMPF is the first open access journal in Indonesia specialized in both research of pharmaceutical management and pharmacy practice. Articles submitted in JMPF are peer reviewed, we accept review articles and original research articles with no submission/publication fees. JMPF receives manuscripts ...