Paediatric Guidelines: Introduction
Children are often subjected to a variety of painful diagnostic and therapeutic procedures. Immaturity and cognitive impairment may preclude competent expression of pain during such experiences. Therefore, the need for analgesia may not be sufficiently addressed. Pain assessment and measurement are prerequisites to optimal pain management. Pain measurement tools are available for children of all
Children are often subjected to a variety of painful diagnostic and therapeutic procedures. Immaturity and cognitive impairment may preclude competent expression of pain during such experiences. Therefore, the need for analgesia may not be sufficiently addressed.
Pain assessment and measurement are prerequisites to optimal pain management. Pain measurement tools are available for children of all ages and cognitive ability. Methods of pain assessment as well as treatment guidelines for the paediatric population are well established, but not widely used. The use of pain scores allows the practitioner to select appropriate analgesia for the severity of pain, which improves pain control. Reassessment and regular documentation after initiating management indicate efficacy in pain management. The correct tool is appropriate both developmentally for the child and to the clinical context, and can be used consistently.
Inadequate pain management has physiological, psychological, social and economic consequences, and is an ethical and legal dilemma. Neonates and infants are particularly vulnerable due to the neuroplasticity of their immature nervous systems, with emerging evidence of poorer neurodevelopmental outcomes as a result of repeated painful stimuli without adequate analgesia. There is a dearth of literature demonstrating moderate to severe pain in the paediatric inpatient population, regardless of a medical or surgical diagnosis, as a result of inappropriate and inadequate pain management.
South African Society of Anaesthesiologists (SASA) Guidelines for the Management of Acute Pain in Specific Scenarios 2022