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Pain treatment of infants and children in emergency

Giuseppe A. Marraro , Giuseppe A. Marraro

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Indian Journal of Trauma and Emergency Pediatrics 3(1):p 15-28, January - March 2011. | DOI:

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Abstract

To review pain therapies utilized in pediatric age in intra and extra hospital emergency, according to present updated evidence and best practice. Research and data: Literature search using the key words pain, analgesia, sedation, infant, children, pediatric, emergency, postoperative care, PICU, NICU, mechanical ventilation, alone or associated. Intervention: None. Results: A progression in the handling according to the needs of children is necessary in order to apply the appropriate pain treatment reducing side effects in emergency and immediately post-care. Even in less stressed environments, the best way to assess children’s pain remains controversial, with many different methods available. Prolonged analgesia must be titrated during the assessing phase (1-3 hours), the reassessing process for confirming analgesic efficacy and finally the re-evaluation of analgesia in order to highlight the efficacy and adverse effects. Conclusions: Assessment of pain in children is one of the most challenging problems in emergency settings, where the interplay of emotion, fear and pain are so difficult to separate, and the time available for assessment is limited. No consensus exists on which pharmacologic regimens for procedural sedation/analgesia are safest and most effective in emergency, and in several cases the children still are undertreated.

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