What methods of pediatric pain management can be incorporated into a generalist's anesthesia practice?

Historically, pain in ill and injured pediatric patients has not been recognized or attended to. Subsequently, children often suffer in silence. Caretakers are often fearful to intervene aggressively to alleviate pain. A critical evaluation and integrative approach to the treatment of pediatric pain has only recently emerged, and curricula addressing the physiologic, behavioral, and biochemical differences related to pain has only recently been instituted in some medical schools and pediatric training programs. Children deserve special consideration in pain management since they may not be capable of comprehending the need for painful procedures and may not have learned strategies to cope with them. The importance of a comprehensive evaluation can not be overstated. The anesthetist can be of great assistance in pain management of the pediatric surgical patient by assessing his patient's postoperative pain needs and planning his/her anesthetic technique and recovery room course accordingly. Research in pediatric pain is still in its infancy, with crucial issues yet to be addressed. One of the most important is how to individualize the treatment of pain. We also need to learn more about children's natural coping styles and how parents and health care providers can enhance their effectiveness in contributing to the therapeutic team. It is hoped that readers will notice their patient's behaviors a little more closely, think about the extent of their private suffering, and become willing to offer a more studied, justifiable, and aggressive approach to pediatric pain management.