[Special features of procedures in paediatric orthopaedics]
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1Stiftung Orthopädische Universitätsklinik, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Deutschland. kerstin.schroeder@ok.uni-heidelberg.de
Insights
Effective pediatric orthopedic pain management requires a multimodal approach, considering children
Area of Science:
- Pediatric Orthopedics
- Pain Management
- Anesthesiology
Background:
- Perioperative pain treatment is crucial for successful pediatric orthopedic outcomes.
- Pediatric pain management shares similarities with adult guidelines but requires adaptations.
- Key differences in pediatric pain include communication barriers, altered pharmacokinetics, and unique pain perception.
Purpose of the Study:
- To present concepts for effective perioperative analgesia in pediatric orthopedics.
- To highlight the importance of a multimodal approach tailored to pediatric patients.
Main Methods:
- Implementing a multimodal pain management strategy.
- Tailoring workflows and hospital ambiance to children's needs.
- Utilizing pharmacological analgesia, surface, and regional anesthesia.
- Employing a reversed World Health Organization (WHO) pain treatment scheme.
- Ensuring comprehensive pre-procedure information for children and parents.
Main Results:
- A multimodal approach, including tailored environments and pharmacological interventions, is highly effective.
- Early and careful information for children and parents improves the perioperative experience.
- Post-discharge pain management is a necessary component of comprehensive care.
Conclusions:
- Optimizing perioperative pain management in pediatric orthopedics is essential for good outcomes.
- A multimodal strategy adapted to children's specific needs, including communication and pharmacokinetics, is recommended.
- Comprehensive pain management extends beyond the surgical procedure to include post-discharge care.
Abstract:
To get good to excellent results in paediatric orthopaedics perioperative pain treatment is essential. Guidelines are in general similar to those for adults. Some special features should be taken into account. Differences are reduced possibilities of communication in the early years, different pharmacokinetics and a different perception of pain itself. A multimodal approach has proven to be very effective: workflow tailored to children's needs, ambiance appropriate for children and pharmacological analgesia. Children and parents have to be informed carefully about procedures, hospital setting and pain therapy in the first session. Pain therapy is orientated to the reversed WHO pain treatment scheme completed by surface and regional anaesthesia. After discharge pain treatment has to be administered. This article presents concepts of perioperative analgesia.
