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[血友病儿童和青少年的疼痛治疗:专家小组建议]

[Pain therapy for children and adolescents with hemophilia : Recommendations by an expert panel].

作者信息

Stromer W, Messerer B, Crevenna R, Hemberger S H, Jauk B, Schwarz R, Streif W, Thom K, Wagner B, Zwiauer K, Likar R

机构信息

Abteilung für Anästhesie und allg. Intensivmedizin, Landesklinikum Waldviertel Horn, Spitalgasse 8/7/9, 3580, Horn, Österreich.

Universitätsklinik für Anästhesiologie und Intensivmedizin, LKH-Univ.-Klinikum Graz, Graz, Österreich.

出版信息

Schmerz. 2018 Dec;32(6):404-418. doi: 10.1007/s00482-018-0321-7.

Abstract

BACKGROUND

Children and adolescents with severe hemophilia commonly suffer from acute and chronic pain as a consequence of hemophilia-related bleeding. Intervention-related pain also plays a major role. Despite its high prevalence in this patient group, hemophilia-related pain is not always adequately addressed and sufficiently treated.

OBJECTIVES

This paper discusses how to improve pain management for children and adolescents (0-18 years) with hemophilia and which specific features in this population should influence decisions in pain management.

MATERIALS AND METHODS

An expert panel discussed challenges in pain treatment in children and adolescents with hemophilia. Recommendations are based on evidence and clinical experience.

RESULT

Pain management in children with hemophilia needs improvement. Children with hemophilia are at risk of developing chronic pain and of suffering traumatization due to insufficient pain management. Pain therapy can be challenging in these children as both their age and the underlying disease limit the options in particular in pain medication. The expert panel developed recommendations to improve pain management in children with hemophilia.

摘要

背景

患有严重血友病的儿童和青少年常因血友病相关出血而遭受急性和慢性疼痛。与干预相关的疼痛也起主要作用。尽管血友病相关疼痛在该患者群体中普遍存在,但并不总是得到充分关注和有效治疗。

目的

本文讨论如何改善血友病儿童和青少年(0至18岁)的疼痛管理,以及该人群的哪些特殊特征应影响疼痛管理决策。

材料与方法

一个专家小组讨论了血友病儿童和青少年疼痛治疗中的挑战。建议基于证据和临床经验。

结果

血友病儿童的疼痛管理需要改善。血友病儿童有因疼痛管理不足而发展为慢性疼痛和遭受创伤的风险。由于年龄和基础疾病,尤其是在疼痛药物治疗方面限制了选择,这些儿童的疼痛治疗可能具有挑战性。专家小组制定了改善血友病儿童疼痛管理的建议。

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