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Improvements Needed for Pain Management in Children

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Although progress has been made in understanding pain in infants and children, these patients do not always receive the pain management they need, according to an article in the Nov. 12 issue of the Journal of the American Medical Association.

“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,” the author wrote. “There is a lack of comparable randomized controlled trials of children's pain management, and consequently there are relatively few published meta-analyses or systematic reviews.”

“Commonly used definitions of pain emphasize its personal sensory, emotional, and contextual nature, placing much reliance on an individual's ability to express what he or she feels when in pain. Children, particularly those who are preverbal or with limited cognitive capability, are clearly disadvantaged by this approach.” The author noted that “a subject of considerable interest recently is the discovery that the experience of pain in early life may lead to long-term consequences. … 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.”

© 2003 Lippincott Williams & Wilkins, Inc.

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