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Current guidelines for the treatment of acute pain in children
1Department of Pharmacy, Mott Children's and Holden Hospitals, Ann Arbor, Michigan, USA.
Insights
Children, including neonates, can feel pain and require effective treatment. Pain assessment in nonverbal infants is challenging, but physiological responses guide effective pain management strategies.
Area of Science:
- Pediatric Pain Management
- Neonatal Analgesia
- Pediatric Anesthesiology
Background:
- Neonates, infants, and children experience pain similarly to adults.
- Pain assessment in preverbal children presents significant challenges.
- Physiological and behavioral responses to pain are evident early in development.
Purpose of the Study:
- To review current understanding of pain in pediatric populations.
- To discuss effective pain management strategies for neonates, infants, and children.
- To highlight future research priorities in pediatric pain relief.
Main Methods:
- Review of systemic opioid and nonopioid analgesics.
- Discussion of local anesthetic efficacy.
- Consideration of age- and organ function-based dosage modifications.
Main Results:
- Various analgesics (opioids, nonopioids, local anesthetics) are effective when tailored to pain type and intensity.
- Nonopioid analgesics can supplement opioid therapy, reducing opioid dosage.
- Appropriate opioid use and weaning schedules minimize risks of dependence and withdrawal.
Conclusions:
- Effective pain management in pediatric patients requires careful selection and dosing of analgesics.
- Minimizing adverse effects and improving administration techniques (e.g., noninvasive methods) are crucial research areas.
- Addressing pain in pediatric populations is essential for optimal outcomes.
Abstract:
Premature and full-term neonates, infants and children are capable of experiencing pain just like adults, and deserve aggressive treatment. Assessment of pain is difficult in the preverbal group. However, physiological and behavioural responses to noxious stimuli are well developed even in the fetus, and modifying these responses through treatment can affect outcome. Treatment options include systemic opioid and nonopioid analgesics as well as local anaesthetics, all of which are effective when chosen on the basis of the type and intensity of the pain. Dosage modification is necessary based on age and organ function. Nonopioid analgesics are useful supplements to reduce opioid analgesic dose and should be used when indicated. Drug dependence and withdrawal can be avoided by using the opioids appropriately and following logical weaning schedules after long term use of these agents. Use of needles for administering analgesia is still an intimidating part of the process for young children. The development of drugs having fewer adverse effects and noninvasive administration techniques will be important research priorities in the future.