REVIEWS   

Minerva Pediatrica 2010 April;62(2):189-202

Copyright © 2010 EDIZIONI MINERVA MEDICA

language: English

Managing pain in critically ill children

Gandhi M. ¹, Playfor S. D. ² ✉

¹ Department of Pediatric Anesthesia Royal Manchester Children’s Hospital, Manchester, UK 2 Honorary Clinical Lecturer in Pediatric Intensive Care Medicine Pediatric Intensive Care Unit Royal Manchester Children’s Hospital, Manchester, UK

There are many sources of pain for children in the Pediatric Intensive Care Unit (PICU) including underlying pathophysiological processes, surgery, and therapeutic procedures. Historically pain has been a common recollection of children discharged from PICU, and in the past pain has been undertreated in critically ill children. Whilst it has long been recognized that untreated pain can have immediate consequences, recent research has demonstrated that the experience of pain in early life can have significant consequences on sensory processing and the response to pain in later life. Questions also remain about the possible long term effects of analgesic agents administered early in life. Clinical guidelines exist for the management of analgesia in critically ill children. Pain should be regularly assessed using an appropriate tool and a therapeutic plan for pain management should routinely be established and regularly reviewed as the clinical condition of the patient changes. Effective analgesia should be provided through the application of multimodal and pre-emptive analgesia utilising both pharmacological and non-pharmacological techniques.