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Opioids in the Management of Acute Pediatric Pain

  • Chapter
Sedation and Analgesia for Diagnostic and Therapeutic Procedures

Part of the book series: Contemporary C Neuroscience ((CCNE))

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Abstract

The treatment and alleviation of pain is a basic human right that exists regardless of age (1–4). Unfortunately, even when their pain is obvious, children frequently receive no treatment, or inadequate treatment, for pain and for painful procedures (5). The newborn and the critically ill child are especially vulnerable to no treatment or undertreatment (6–10). The conventional “wisdom” that children do not respond to nor remember painful experiences to the same degree as adults is simply untrue (11,12). Indeed, all of the nerve pathways essential for the transmission and perception of pain are present and functioning by 24 wk of gestation (13). Recent research in newborn animals has revealed that the failure to provide analgesia for pain results in “rewiring” the nerve pathways responsible for pain transmission in the dorsal horn of the spinal cord and results in increased pain perception for future painful insults (12–17). This confirms human newborn research, in which the failure to provide anesthesia or analgesia for newborn circumcision resulted in short-term physiologic perturbations as well as in longer-term behavioral changes, particularly during immunization (18).

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  1. Myron Yaster MD
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  2. Lynne G. Maxwell MD
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  1. Department of Anesthesiology, University of Michigan Health System, Ann Arbor, MI, USA

    Shobha Malviya MD , Norah N. Naughton MD  & Kevin K. Tremper MD, PhD ,  & 

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Yaster, M., Maxwell, L.G., Kost-Byerly, S. (2003). Opioids in the Management of Acute Pediatric Pain. In: Malviya, S., Naughton, N.N., Tremper, K.K. (eds) Sedation and Analgesia for Diagnostic and Therapeutic Procedures. Contemporary Clinical Neuroscience. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-295-1_7

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