Postoperative pain control in children.

Lloyd-Thomas, A.R.; Howard, Richard

doi:10.1136/bmj.304.6835.1174-c

Cited by 9 publications

(2 citation statements)

References 6 publications

(4 reference statements)

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“…Pediatric pain services were first established in larger pediatric centers over two decades ago . Children's acute pain was poorly managed at the time owing to misconceptions , safety concerns , and variability in practice .…”

Section: Introductionmentioning

confidence: 99%

Developing a pediatric pain service

Kost‐Byerly

Chalkiadis

2012

Pediatric Anesthesia

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Pediatric pain services were first established in larger pediatric centers over two decades ago. Children's acute pain was poorly managed at the time owing to misconceptions, safety concerns, and variability in practice. While many larger pediatric centers now have acute pain services, there remains a need for better pain management in facilities and geographic locations with fewer resources. Institutional acknowledgement and desire to change, appropriate staffing, and funding are major obstacles. Better recognition and assessment as well safer and more efficacious treatment of pain are the principal objectives when establishing a pain service. It is important to determine whether the proposed service intends to treat acute, chronic, procedural, and/or cancer and palliative pain as each requires different skills and resources. An ideal and comprehensive pediatric pain service should be equipped to diagnose and treat acute, persistent (chronic), procedural, and cancer/palliative pain. It is not feasible or necessary for every hospital to manage all. Establishing the scope of practice (based on case mix and caseload) in any given hospital will determine which resources are desired. Country-specific standards, local staffing, and fiscal constraints will influence which resources are available.

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Section: Introductionmentioning

confidence: 99%

Developing a pediatric pain service

Kost‐Byerly

Chalkiadis

2012

Pediatric Anesthesia

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“…Recording and assessment of postoperative pain relief are recommended by the Report of the Joint College Working Party on Pain after Surgery [3]. However, detailed consistent assessment can be made only if there are available trained staff who are familiar with the behavioural and subjective effects of pain in children, in a suitable environment [4].…”

mentioning

confidence: 99%

Postoperative Analgesia in Children

Fell¹

1993

British Journal of Anaesthesia

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Post-operative pain relief in children following extraction of carious deciduous teeth under general anaesthesia: a comparison of nalbuphine and diclofenac

Littlejohn¹,

Tarling²,

Flynn³

et al. 1996

Eur J Anaesthesiol

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In a randomized double-blind study 60 children, undergoing the extraction of carious deciduous teeth under day-case general anaesthesia, were assigned to receive either intravenous nalbuphine hydrochloride 0.3 mg kg-1 (n = 21), one or more diclofenac suppositories 12.5 mg to a dose of 1-2 mg kg-1 (n = 19), or no analgesia (n = 20). The duration of anaesthesia was longer in the diclofenac group (9.6 min, SD 3.5) compared with control (7.2 min, SD 2.6) and nalbuphine (6.9 min, SD 3.0) groups respectively (P < 0.05). There were no statistically significant differences in post-operative pain scores during the 45 min post-operative period studied between the three groups using an objective pain score. We conclude that using this methodology we were unable to demonstrate any statistically significant differences between the analgesic effects of either intravenous (i.v.) nalbuphine or diclofenac suppositories compared with control.

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Postoperative pain control in children.

Cited by 9 publications

References 6 publications

Developing a pediatric pain service

Developing a pediatric pain service

Postoperative Analgesia in Children

Post-operative pain relief in children following extraction of carious deciduous teeth under general anaesthesia: a comparison of nalbuphine and diclofenac

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