Pain relief in children

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7144.1552 (Published 23 May 1998) Cite this as: BMJ 1998;316:1552

Doing the simple things better

  1. Mathew Zacharias, Senior lecturer in anaesthesia and intensive care (mathew.zacharias@stonebow.otago.ac.nz),
  2. Duncan Watts, Consultant anaesthetist
  1. Dunedin School of Medicine, Dunedin, New Zealand
  2. Dunedin Hospital, Dunedin, New Zealand

    Paediatric pain management has undergone significant change during the past decade, more so than many other areas of medical practice. Development has grown out of improved understanding of the physiological and psychological effects of unrelieved pain in children, greater insight into the benefits and risks of an aggressive approach to pain management, and greater knowledge of the clinical pharmacology of analgesic drugs in children. The trend towards specialised paediatric units staffed by professionals with training and experience in managing children's diseases has accelerated progress towards optimal pain management, whether for acute, chronic, or cancer pain. Unfortunately current practice still falls short of the ideal of safe and effective pain relief for all children.

    A longstanding problem in paediatric pain management has been the difficulty of objectively assessing pain. Assessment in infants before they can speak is particularly challenging and may have been responsible for perpetuating the myth …

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