Hockenberry Marilyn J, McCarthy Kathy, Taylor Olga, Scarberry Meredith, Franklin Quinn, Louis Chrystal U, Torres Laura
Pediatric Hematology Oncology, Baylor College of Medicine, Texas Children's Cancer Center, Houston, TX, USA.
J Pediatr Hematol Oncol. 2011 Mar;33(2):119-27. doi: 10.1097/MPH.0b013e3181f46a65.
Children with cancer experience repeated invasive and painful medical procedures. Pain and distress does not decrease with repeated procedures and may worsen if pain is not adequately managed. In 1990, the first recommendations on the management of pain and anxiety associated with procedures for children with cancer were published. Guiding principles described in the recommendations continue to hold true today: maximize comfort and minimize pain, use nonpharmacologic and pharmacologic interventions, prepare the child and family, consider the developmental age of the child, support family and child involvement, assure provider competency in performing procedures and sedation, and use appropriate monitoring to assure safety. This article reviews these key components for managing painful procedures in children and reviews the latest pharmacological and nonpharmacological interventions most effective in minimizing pain and discomfort.
患癌儿童要经历多次侵入性且痛苦的医疗程序。疼痛和痛苦不会随着重复的程序而减轻，如果疼痛得不到充分管理，情况可能会恶化。1990年，关于癌症患儿医疗程序相关疼痛和焦虑管理的首批建议发表。这些建议中描述的指导原则如今仍然适用：最大限度地提高舒适度并将疼痛降至最低，采用非药物和药物干预措施，让患儿及其家庭做好准备，考虑患儿的发育年龄，支持家庭和患儿的参与，确保医护人员在实施程序和镇静方面具备能力，并进行适当监测以确保安全。本文回顾了管理儿童痛苦程序的这些关键要素，并回顾了在将疼痛和不适降至最低方面最有效的最新药物和非药物干预措施。
