Author Affiliations: Anaesthesia and Pain Management, Children Nationwide Pain Research Centre, and Department of Anaesthesia, Great Ormond Street Hospital for Children NHS Trust, London, England.
Many changes have taken place in pediatric pain management since the
undertreatment of children's pain was first reported. Notable advances include
an increase in understanding pain during development and improvements in the
management of acute pain. Although much more about the safe and effective
management of pain in children is now known, this knowledge has not been widely
or effectively translated into routine clinical practice. Lack of suitable
research on which to firmly establish evidence-based care is likely to have
contributed to this situation. A subject of considerable interest recently
is the discovery that the experience of pain in early life may lead to long-term
consequences. New research findings from laboratory and clinical studies have
clearly identified possible mechanisms and provided evidence that long-term
behavioral changes can extend far beyond what would be considered the normal
period of postinjury recovery. Timing, degree of injury, and administered
analgesia and its nature may be important determinants of the long-term outcome
of infant pain. Chronic pain, including neuropathic pain, is far more common
in children than was thought. The assessment and treatment of this pain and
its functional consequences present a considerable unmet challenge. There
is a pressing need for further research and clinical development in the management
of pain in children.
Howard RF. Current Status of Pain Management in Children. JAMA. 2003;290(18):2464–2469. doi:10.1001/jama.290.18.2464
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