Acute Pain and Analgesia in children

Abstract

Acute pain is a complex process involving activation of nociceptors, chemical mediators and inflammation. All the major children’s hospitals now have dedicated pain services to provide evaluation and immediate treatment of pain in any child. Children experience pain in a similar way to adults. Pain intensity in children depends on the surgical procedure itself but also on numerous other factors such as age, emotional state or the level of anxiety associated with the hospital stay. The perception and communication of the child’s pain depends on his or her intellectual and social development. Expression of pain therefore relies on the child’s ability to understand, quantitate and communicate it. Previous pain experiences or chronic diseases that required many medical procedures may significantly change the pain threshold in paediatric patients. Moreover, genetic predispositions and environmental effects are significant. The American Academy of Pediatrics and the American Pain Society have reiterated the importance of a multidisciplinary approach in order to eliminate pain in children. In all pediatric settings, an adequate assessment is the initial stage in a proper clinical approach to pain, especially in the emergency departments; therefore, an increasing number of age-related tools have been validated. Systemic opioids, nonsteroidal anti-inflammatory agents and regional analgesics alone or combined with additives are currently used to provide effective postoperative analgesia. These modalities are best utilized when combined as a multimodal approach to treat acute pain in the perioperative setting. The total number of behaviors that are present in the child are used to estimate his/her pain at the time of assessment. Pain assessment is important to facilitate effective postoperative pain management in these vulnerable children. The purpose of this study is to investigate acute pain as well as analgesia and availability of the used analgesic drugs in children. A multimodal approach to preventing and treating pain is usually used.