Pain in Children: A State of the Art

Abstract

The last two decades have witnessed a surge in interest among health professionals for the topic pain in children. The work conducted by researchers and clinicians in this area has led to an increase in knowledge regarding pain mechanisms, pain pathways and pain perception. In addition, pain assessment and pain management strategies have been developed and in some cases rigorously subjected to scientific testing. As a result of these developments, the number of myths which have haunted this area of practice have been partially dispelled. The notion that children are less capable of feeling, remembering, and reporting pain has been questioned by researchers. Evidence is as a result accumulating that pain perception in infants is not dependent on the degree of myelination and that pain pathways are formed before birth (Fitzgerald, 1993; Fitzgerald & Anand, 1994). In addition a number of studies have shown beginning evidence that neonates and infants can remember pain. Finally, the child’s ability to report pain as early as three years of age has been supported by numerous research studies (Abu-Saad et al, 1994, Beyer et al, 1990; Hamers et al, 1996; McGrath, 1990).