Journal ArticleDOI
Pain, Hurt, and Harm -- The Ethics of Pain Control in Infants and Children
TLDR
The tendency toward undermedication for pain is even more pronounced in children than in adults, and there are large discrepancies between the amounts of postoperative analgesia ordered for and administered to adults and those orders for and administer to children.Abstract:
It has long been recognized that patients receive less relief from pain than they should1,2. A recent review concluded that pain can be relieved effectively in 90 percent of patients but is not relieved effectively in 80 percent of patients3. The tendency toward undermedication for pain is even more pronounced in children than in adults4. There are large discrepancies between the amounts of postoperative analgesia ordered for and administered to adults and those ordered for and administered to children who have the same diagnoses and have undergone the same procedures5,6. Interest in pain control . . .read more
Citations
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Journal ArticleDOI
The Assessment and Management of Acute Pain in Infants, Children, and Adolescents
TL;DR: Pediatricians need to expand their knowledge, use appropriate assessment tools and techniques, anticipate painful experiences and intervene accordingly, use a multi-modal approach to pain management,Use a multidisciplinary approach when possible, involve families, and advocate for the use of effective pain management in children.
Journal ArticleDOI
Recommendations for end-of-life care in the intensive care unit: The Ethics Committee of the Society of Critical Care Medicine.
Robert D. Truog,Alexandra F. M. Cist,Sharon Brackett,Jeffrey P. Burns,Martha A. Q. Curley,Marion Danis,Michael A. DeVita,Stanley H. Rosenbaum,David Rothenberg,Charles L. Sprung,Sally A. Webb,Ginger Schafer Wlody,William E. Hurford +12 more
TL;DR: These recommendations are written from the emerging perspective that palliative care and intensive care are not mutually exclusive options but rather should be coexistent.
Journal ArticleDOI
Clinical importance of pain and stress in preterm neonates
TL;DR: Long-term follow-up studies of preterm neonates may substantiate the preliminary data associating repetitive painful experiences with some of the neurobehavioral and developmental sequelae resulting from neonatal intensive care.
Journal ArticleDOI
Analgesics for the Treatment of Pain in Children
Charles B. Berde,Navil F. Sethna +1 more
TL;DR: The development of nociception; the differences in metabolism of analgesics among infants, children, and adults; and agents that can be used for pain control in a variety of settings are discussed.
Journal ArticleDOI
Pediatric procedural pain.
TL;DR: The evidence for long-term negative effects of inadequately treated procedural pain, the determinants of an individual's pain response, tools to assess pain in children, and interventions to reduce procedural pain and distress are reviewed.
References
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Journal ArticleDOI
Pain and its effects in the human neonate and fetus
TL;DR: The body of scientific evidence regarding the mechanisms and effects of nociceptive activity in newborn infants has not been addressed directly and the pervasive view of neonatal pain is that newborns are frequently not given analgesic or anesthetic agents during invasive procedures, including surgery.
Journal ArticleDOI
Do practice guidelines guide practice? The effect of a consensus statement on the practice of physicians.
Jonathan Lomas,Geoffrey M. Anderson,Karin Domnick-Pierre,Eugene Vayda,Murray Enkin,Walter J. Hannah +5 more
TL;DR: It is concluded that guidelines for practice may predispose physicians to consider changing their behavior, but that unless there are other incentives or the removal of disincentives, guidelines may be unlikely to effect rapid change in actual practice.
Journal ArticleDOI
Undertreatment of Medical Inpatients with Narcotic Analgesics
TL;DR: Structured interviews of medical inpatients being treated with narcotic analgesics for pain showed that 32% of the patients were continuing to experience severe distress, despite the treatment, according to the authors.
Journal ArticleDOI
Pain expression in neonates: facial action and cry☆
Ruth E. Grunau,Kenneth D. Craig +1 more
TL;DR: The findings of facial action variation across sleep/waking state were interpreted as indicating that the biological and behavioral context of pain events affects behavioral expression, even at the earliest time developmentally, before the opportunity for learned response patterns occurs.
Journal ArticleDOI
Randomised trial of fentanyl anaesthesia in preterm babies undergoing surgery: effects on the stress response
TL;DR: It is indicated that preterm babies mount a substantial stress response to surgery under anaesthesia with nitrous oxide and curare and that prevention of this response by fentanyl anaesthesia may be associated with an improved postoperative outcome.