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Curr Pediatr Res 2017; 21 (1): 148-157
Assessment and treatment of pain in pediatric patients.
Halefom Kahsay
Department of Pharmacy, Collage of Health Science, Adigrat University, Adigrat, Ethiopia.
Pediatric patients experience pain which is more difficult to assess and treat relatively to
adults. Evidence demonstrates that controlling pain in the pediatrics age period is beneficial,
improving physiologic, behavioral, and hormonal outcomes. Multiple validated scoring
systems exist to assess pain in pediatrics; however, there is no standardized or universal
approach for pain management. Healthcare facilities should establish pediatrics pain control
program. This review summaries a collection of pain assessment tools and management
practices in different facilities. This systematic approach should decrease pediatric pain and
poor outcomes as well as improve provider and parent satisfaction.
Keywords: Pain, Pain assessment, Pain management, Pediatric patients.
Introduction
According to the International Association for the Study of
Pain (IASP) Pain is "an un-pleasant sensory and emotional
experience associated with actual and potential tissue
damage". Pain has also been defined as "existing whenever
they say it does rather than whatever the experiencing
person says" [1-4]. It is one of the most dreading and
devastating symptom commonly propagated in peoples
with advanced chronic conditions including cancer patents.
Pediatric patients are the most under treated and present to
hospital for pain compared to adults; because of the wrong
belief that they neither suffer pain nor they remember
painful experiences [5]. The quality of life experienced
by the patient can greatly reduce, regardless of their basic
diagnosis. Thus, if pain will be poorly managed, it can
reflect the influence on family and careers causing different
which may leads to increased rates of hospital admission
[5,6]. Uncontrolled pain has also direct impact on health
outcomes and more than a few effects on all areas of life.
The emotional, cognitive, and behavioral components of
pediatric patient are also important to assess pain and to
simplify the management practices [7,8].
A long-term negative effect of untreated pain on pain
sensitivity, immune
attitudes, and health care behavior are supported with
numerous evidences. Health care professionals' who care
for children are mainly responsible for abolishing or
assuaging pain and suffering when possible [5,7,9]. The
practice of pediatric pain treatment protocol has made
great progress in the last decade with the development
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functioning, neurophysiology,
Abstract
and validation of pain valuation tools specific to pediatric
patients. Almost all the major children hospitals now
have dedicated pain services to provide evaluation and
immediate treatment of pain in any child [10,11].
In pediatric age, it is more difficult to assess and treat pain
effectively relatively to adults. The lack of ability to notice
pain, immaturity of remembering painful experiences
and other reasons are the reflection of persistence of
myths related to the infant's ability to perceive pain [12].
However, the treatment of pain in childhood is like the adult
management practice which includes pharmacological and
non-pharmacological interventions. On the other hand,
it critically depends on an in-depth understand of the
developmental and environmental factors that influence
nociceptive processing, pain perception and the response
to treatment during maturation from infancy to adolescence
[13,14].
The practice of assessing pain and its management in
pediatric patients can show a discrepancy based on the
different countries and their respective health institutions.
So, this review focused on the contemporary practice
and new advances in pediatric pain assessment and its
management.
Classification of Pain
Many classification systems are used to describe the
different types of pain. The most common classification
schemes refer to pain as acute or chronic; malignant or
nonmalignant; and nociceptive or neuropathic [15]. Most
studies are agreed with the following classification of pain
(Table 1).
ISSN 0971-9032
www.currentpediatrics.com
Accepted January 30, 2017
Curr Pediatr Res 2017 Volume 21 Issue 1