Scope of physiological and behavioural pain assessment techniques in children - a review

Area of Science:

• Biomedical Engineering
• Pain Medicine
• Pediatrics

Background:

• Current pain assessment methods (self-report, scales) are subjective and limited in children with cognitive impairments.
• These methods are also inefficient for precise analgesic dosage titration post-surgery.
• There is a need for objective, automated pain evaluation tools.

Purpose of the Study:

• To highlight the demand for automatic pain coding techniques.
• To review objective methods for pain assessment in children.
• To explore alternative approaches beyond traditional pain scales.

Main Methods:

• Review of existing literature on objective pain indicators.
• Analysis of techniques utilizing facial expressions (RGB imaging) and thermal imaging.
• Examination of physiological signals: electrocardiogram, skin conductance, body temperature, surgical pleth index, pupillary reflex dilation, analgesia nociception index, photoplethysmography, and perfusion index.

Main Results:

• Facial expressions and thermal imaging offer visual pain cues.
• Physiological signals provide quantifiable data for pain monitoring.
• Several validated physiological indicators show promise for objective pain measurement.

Conclusions:

• Objective pain assessment in children, particularly those with cognitive disorders, requires advanced techniques.
• Automatic coding and analysis of physiological signals present a viable alternative to subjective pain scales.
• Further research into these objective methods can improve pain management and treatment efficacy in pediatric patients.