[Special features of procedures in paediatric orthopaedics]

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.