Abstract
The main remit of the European Society for Paediatric Anaesthesiology (ESPA) Pain Committee is to improve the quality of pain management in children. The ESPA Pain Management Ladder is a clinical practice advisory based upon expert consensus to help to ensure a basic standard of perioperative pain management for all children. Further steps are suggested to improve pain management once a basic standard has been achieved. The guidance is grouped by the type of surgical procedure and layered to suggest basic, intermediate, and advanced pain management methods. The committee members are aware that there are marked differences in financial and personal resources in different institutions and countries and also considerable variations in the availability of analgesic drugs across Europe. We recommend that the guidance should be used as a framework to guide best practice.
Highlights
Adequate pain therapy cannot be taken for granted
The European Society for Paediatric Anaesthesiology (ESPA) Pain Management Ladder is a clinical practice advisory based upon the consensus opinions of these working groups
Oral and rectal administration of nonopioid drugs and regional anesthesia play a crucial role since they are available in most places.[17,18,19,20,21]
Summary
Adequate pain therapy cannot be taken for granted. the Declaration of Montreal (September 2010) states that “Access to Pain Management is a Fundamental Right”, it is estimated that 80% of the global population is affected by insufficient pain management, and this is a serious problem in over 150 countries. The greatest burden of inadequate pain management is carried by the elderly, pregnant, and breastfeeding women, children, drug addicted persons, and the mentally ill. For many years there have been increasing efforts to improve the perioperative pain management of children but there are still a substantial number of children suffering perioperative pain.. Even in more affluent settings, pediatric postoperative pain management is highly variable and is still suboptimal in many centers.[12]. Against this background, it is important to define the minimum standards of pediatric postoperative pain relief that children can expect after surgical procedures even in settings with limited resources. It is important to outline how pediatric postoperative pain relief may evolve and improve. The aim of the current ESPA initiative is to provide a consensus practice advisory document analogous to the WHO Pain Relief Ladder,[14] based pragmatically upon existing evidence and already published guidelines, to improve pediatric postoperative pain relief in Europe. Primarily aimed at the European continent, we hope that it may be applied in other countries around the world
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