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Pain management of the pediatric patient
1Vanderbilt University School of Medicine, Nashville, Tennessee.
Insights
Managing pediatric pain involves a step-wise approach. Mild pain uses nonsteroidal anti-inflammatory drugs (NSAIDs), while moderate to severe pain may require narcotics or advanced techniques like patient-controlled analgesia (PCA).
Area of Science:
- Pediatric Medicine
- Pain Management
- Pharmacology
Background:
- Pain has significant negative physiological effects in children.
- Effective pain management is crucial for pediatric patient outcomes.
- Current treatment strategies require a structured approach based on pain severity.
Purpose of the Study:
- To outline a step-wise approach for managing pediatric pain.
- To provide guidance on selecting appropriate analgesics based on pain intensity.
- To discuss advanced pain management techniques for severe cases.
Main Methods:
- A step-wise treatment protocol based on pain severity is described.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are recommended for mild pain.
- Oral narcotics and regional anesthetic techniques or patient-controlled analgesia (PCA) are considered for moderate to severe pain.
Main Results:
- Mild pain is manageable with NSAIDs like ibuprofen.
- Moderate pain may necessitate the addition of oral narcotics.
- Severe pain can be treated with regional anesthesia or intravenous narcotics via PCA.
Conclusions:
- A graded approach effectively manages pediatric pain.
- Pharmacological and interventional strategies should be tailored to pain severity.
- Consultation with pediatric pain management specialists is advised for refractory cases.
Abstract:
Recent evidence has documented the deleterious physiologic effects of pain. The treatment of pain in children may be guided by a step-wise approach depending on its severity (Table 2). Mild pain can generally be controlled with a NSAID, such as ibuprofen, whereas moderate pain may require the addition of an orally active narcotic. Several approaches may be taken for the treatment of severe pain, including regional anesthetic techniques or the use of PCA to deliver intravenous narcotics. When such techniques fail, consultation with specialists in the field of pediatric pain management may be helpful.