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Anesthesiology pp 445-456 | Cite as

Pediatric Pain Management

  • Jennifer Hickman
  • Jaya L. Varadarajan
Chapter

Abstract

The International Association for the Study of Pain defines pain as an unpleasant sensory and emotional experience associated with actual or potential tissue damage (Cunliffe and Roberts, Curr Anaesth Crit Care 15(4–5):272–283, 2004). The application of the word “pain” is a learned response based on experiences related to injury early in life. Professionals caring for children need to be aware that children are a vulnerable group, and give appropriate consideration and treatment to a child reporting pain to avoid long-term consequences. This chapter will address the neurobiology of pain in children, assessment tools for quantifying pain in children, and approaches to pharmacology of treating pain in children.

Keywords

Wong-Baker FLACC Nips Faces Pain Scale-Revised Pediatric PCA Pediatric neurobiology Caudal Epidural Cognitive behavioral therapy Child life specialist 

References

  1. 1.
    Cunliffe M, Roberts SA. Pain management in children. Curr Anaesth Crit Care. 2004;15(4–5):272–83.CrossRefGoogle Scholar
  2. 2.
    Purcell-Jones G, Dormon F, Sumner E. Paediatric anaesthetists’ perceptions of neonatal and infant pain. Pain. 1988;33(2):181–7.CrossRefPubMedGoogle Scholar
  3. 3.
    Loizzo A, Loizzo S, Capasso A. Neurobiology of pain in children: an overview. Open Biochem J. 2009;3:18–25.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Anand KJ, Sippell WG, Aynsley-Green A. Randomised trial of fentanyl anaesthesia in preterm babies undergoing surgery: effects on the stress response. Lancet. 1987;1(8524):62–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Molliver ME, Kostovic I, van der Loos H. The development of synapses in cerebral cortex of the human fetus. Brain Res. 1973;50(2):403–7.CrossRefPubMedGoogle Scholar
  6. 6.
    Charnay Y, Paulin C, Chayvialle JA, Dubois PM. Distribution of substance P-like immunoreactivity in the spinal cord and dorsal root ganglia of the human foetus and infant. Neuroscience. 1983;10(1):41–55.CrossRefPubMedGoogle Scholar
  7. 7.
    Taddio A, Katz J, Ilersich AL, Koren G. Effect of neonatal circumcision on pain response during subsequent routine vaccination. Lancet. 1997;349(9052):599–603.CrossRefPubMedGoogle Scholar
  8. 8.
    Drendel AL, Kelly BT, Ali S. Pain assessment for children: overcoming challenges and optimizing care. Pediatr Emerg Care. 2011;27(8):773–81.CrossRefPubMedGoogle Scholar
  9. 9.
    Suraseranivongse S, Kaosaard R, Intakong P, Pornsiriprasert S, Karnchana Y, Kaopinpruck J, et al. A comparison of postoperative pain scales in neonates. Br J Anaesth. 2006;97(4):540–4.CrossRefPubMedGoogle Scholar
  10. 10.
    Malviya S, Voepel-Lewis T, Burke C, Merkel S, Tait AR. The revised FLACC observational pain tool: improved reliability and validity for pain assessment in children with cognitive impairment. Paediatr Anaesth. 2006;16(3):258–65.CrossRefPubMedGoogle Scholar
  11. 11.
    Bieri D, Reeve RA, Champion GD, Addicoat L, Ziegler JB. The Faces Pain Scale for the self-assessment of the severity of pain experienced by children: development, initial validation, and preliminary investigation for ratio scale properties. Pain. 1990;41(2):139–50.CrossRefPubMedGoogle Scholar
  12. 12.
    Hicks CL, von Baeyer CL, Spafford PA, van Korlaar I, Goodenough B. The Faces Pain Scale-Revised: toward a common metric in pediatric pain measurement. Pain. 2001;93(2):173–83.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Garra G, Singer AJ, Taira BR, Chohan J, Cardoz H, Chisena E, et al. Validation of the Wong-Baker FACES Pain Rating Scale in pediatric emergency department patients. Acad Emerg Med. 2010;17(1):50–4.CrossRefPubMedGoogle Scholar
  14. 14.
    von Baeyer CL, Marche TA, Rocha EM, Salmon K. Children's memory for pain: overview and implications for practice. J Pain. 2004;5(5):241–9.CrossRefGoogle Scholar
  15. 15.
    Shavit I, Kofman M, Leder M, Hod T, Kozer E. Observational pain assessment versus self-report in paediatric triage. Emerg Med J. 2008;25(9):552–5.CrossRefPubMedGoogle Scholar
  16. 16.
    Anderson BJ. Paracetamol (acetaminophen): mechanisms of action. Pediatr Anesth. 2008;18(10):915–21.CrossRefGoogle Scholar
  17. 17.
    Anderson BJ, Rees SG, Liley A, Stewart AW, Wardill MJ. Effect of preoperative paracetamol on gastric volumes and pH in children. Pediatr Anesth. 1999;9(3):203–7.Google Scholar
  18. 18.
    Birmingham PK, Tobin MJ, Fisher DM, Henthorn TK, Hall SC, Cote CJ. Initial and subsequent dosing of rectal acetaminophen in children: a 24-hour pharmacokinetic study of new dose recommendations. Anesthesiology. 2001;94(3):385–9.CrossRefPubMedGoogle Scholar
  19. 19.
    Kumpulainen E, Kokki H, Halonen T, Heikkinen M, Savolainen J, Laisalmi M. Paracetamol (acetaminophen) penetrates readily into the cerebrospinal fluid of children after intravenous administration. Pediatrics. 2007;119(4):766–71.CrossRefPubMedGoogle Scholar
  20. 20.
    Lesko SM, Mitchell AA. An assessment of the safety of pediatric ibuprofen. A practitioner-based randomized clinical trial. JAMA. 1995;273(12):929–33.CrossRefPubMedGoogle Scholar
  21. 21.
    Clark E, Plint AC, Correll R, Gaboury I, Passi B. A randomized, controlled trial of acetaminophen, ibuprofen, and codeine for acute pain relief in children with musculoskeletal trauma. Pediatrics. 2007;119(3):460–7.CrossRefPubMedGoogle Scholar
  22. 22.
    Vetter TR, Heiner EJ. Intravenous ketorolac as an adjuvant to pediatric patient-controlled analgesia with morphine. J Clin Anesth. 1994;6(2):110–3.CrossRefPubMedGoogle Scholar
  23. 23.
    Michelet D, Andreu-Gallien J, Bensalah T, Hilly J, Wood C, Nivoche Y, et al. A meta-analysis of the use of nonsteroidal antiinflammatory drugs for pediatric postoperative pain. Anesth Analg. 2012;114(2):393–406.CrossRefPubMedGoogle Scholar
  24. 24.
    Kraemer FW. Treatment of acute pediatric pain. Semin Pediatr Neurol. 2010;17(4):268–74.CrossRefPubMedGoogle Scholar
  25. 25.
    Berde CB, Sethna NF. Analgesics for the treatment of pain in children. N Engl J Med. 2002;347(14):1094–103.CrossRefPubMedGoogle Scholar
  26. 26.
    Collins C, Koren G, Crean P, Klein J, Roy WL, MacLeod SM. Fentanyl pharmacokinetics and hemodynamic effects in preterm infants during ligation of patent ductus arteriosus. Anesth Analg. 1985;64(11):1078–80.CrossRefPubMedGoogle Scholar
  27. 27.
    Gasche Y, Daali Y, Fathi M, Chiappe A, Cottini S, Dayer P, et al. Codeine intoxication associated with ultrarapid CYP2D6 metabolism. N Engl J Med. 2004;351(27):2827–31.CrossRefPubMedGoogle Scholar
  28. 28.
    Monitto CL, Greenberg RS, Kost-Byerly S, Wetzel R, Billett C, Lebet RM, et al. The safety and efficacy of parent-/nurse-controlled analgesia in patients less than six years of age. Anesth Analg. 2000;91(3):573–9.CrossRefPubMedGoogle Scholar
  29. 29.
    Fu ES, Downs JB, Schweiger JW, Miguel RV, Smith RA. Supplemental oxygen impairs detection of hypoventilation by pulse oximetry. Chest. 2004;126(5):1552–8.CrossRefPubMedGoogle Scholar
  30. 30.
    Hart LS, Berns SD, Houck CS, Boenning DA. The value of end-tidal CO2 monitoring when comparing three methods of conscious sedation for children undergoing painful procedures in the emergency department. Pediatr Emerg Care. 1997;13(3):189–93.CrossRefPubMedGoogle Scholar
  31. 31.
    Wrona S, Chisolm DJ, Powers M, Miler V. Improving processes of care in patient-controlled analgesia: the impact of computerized order sets and acute pain service patient management. Paediatr Anaesth. 2007;17(11):1083–9.CrossRefPubMedGoogle Scholar
  32. 32.
    Rusy LM, Hainsworth KR, Nelson TJ, Czarnecki ML, Tassone JC, Thometz JG, et al. Gabapentin use in pediatric spinal fusion patients: a randomized, double-blind, controlled trial. Anesth Analg. 2010;110(5):1393–8.CrossRefPubMedGoogle Scholar
  33. 33.
    Tryba M, Gehling M. Clonidine—a potent analgesic adjuvant. Curr Opin Anaesthesiol. 2002;15(5):511–7.CrossRefPubMedGoogle Scholar
  34. 34.
    Rosen KR, Rosen DA. Caudal epidural morphine for control of pain following open heart surgery in children. Anesthesiology. 1989;70(3):418–21.CrossRefPubMedGoogle Scholar
  35. 35.
    Wolf AR, Hughes D, Wade A, Mather SJ, Prys-Roberts C. Postoperative analgesia after paediatric orchidopexy: evaluation of a bupivacaine-morphine mixture. Br J Anaesth. 1990;64(4):430–5.CrossRefPubMedGoogle Scholar
  36. 36.
    Agarwal R, Gutlove DP, Lockhart CH. Seizures occurring in pediatric patients receiving continuous infusion of bupivacaine. Anesth Analg. 1992;75(2):284–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Pediatric AnesthesiologyChildren’s Hospital of WisconsinMilwaukeeUSA
  2. 2.Anesthesia and PediatricsChildren’s Hospital of WisconsinMilwaukeeUSA

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