Current status of pain management in children
Current status of pain management in children
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DOI：
10.1001/jama.290.18.2464
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发表时间：
2003-11-12
影响因子：
120.7
通讯作者：
Howard, RF
中科院分区：
文献类型：
--
作者：
Howard, RF
自从首次报道儿童疼痛治疗不足以来，儿科疼痛管理发生了许多变化。值得注意的进展包括在发展过程中对疼痛的理解的增加和急性疼痛管理的改善。虽然现在已经知道更多关于儿童疼痛的安全有效管理，但这些知识尚未广泛或有效地转化为常规临床实践。缺乏适当的研究，以牢固地建立以证据为基础的护理可能是造成这种情况。最近一个相当有趣的主题是发现早期生活中的疼痛经历可能导致长期后果。来自实验室和临床研究的新研究结果清楚地确定了可能的机制，并提供了证据表明，长期行为变化可以远远超出正常的损伤后恢复期。时机，损伤程度，镇痛及其性质可能是婴儿疼痛长期结局的重要决定因素。慢性疼痛，包括神经性疼痛，在儿童中比想象中更常见。这种疼痛及其功能后果的评估和治疗是一个相当大的挑战。有迫切需要进一步的研究和临床发展的管理疼痛的儿童。
Many changes have taken place in pediatric pain management since the undertreatment of children's pain was first reported. Notable advances include an increase in understanding pain during development and improvements in the management of acute pain. Although much more about the safe and effective management of pain in children is now known, this knowledge has not been widely or effectively translated into routine clinical practice. Lack of suitable research on which to firmly establish evidence-based care is likely to have contributed to this situation. A subject of considerable interest recently is the discovery that the experience of pain in early life may lead to long-term consequences. New research findings from laboratory and clinical studies have clearly identified possible mechanisms and provided evidence that long-term behavioral changes can extend far beyond what would be considered the normal period of postinjury recovery. Timing, degree of injury, and administered analgesia and its nature may be important determinants of the long-term outcome of infant pain. Chronic pain, including neuropathic pain, is far more common in children than was thought. The assessment and treatment of this pain and its functional consequences present a considerable unmet challenge. There is a pressing need for further research and clinical development in the management of pain in children.