Wren Anava A, Ross Alexandra C, D'Souza Genevieve, Almgren Christina, Feinstein Amanda, Marshall Amanda, Golianu Brenda
Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Stanford University, Palo Alto, CA 94305, USA.
Department of Pediatrics, Child and Adolescent Headache Program, University of California San Francisco, San Francisco, CA 94158, USA.
Children (Basel). 2019 Feb 21;6(2):33. doi: 10.3390/children6020033.
Opioid therapy is the cornerstone of treatment for acute procedural and postoperative pain and is regularly prescribed for severe and debilitating chronic pain conditions. Although beneficial for many patients, opioid therapy may have side effects, limited efficacy, and potential negative outcomes. Multidisciplinary pain management treatments incorporating pharmacological and integrative non-pharmacological therapies have been shown to be effective in acute and chronic pain management for pediatric populations. A multidisciplinary approach can also benefit psychological functioning and quality of life, and may have the potential to reduce reliance on opioids. The aims of this paper are to: (1) provide a brief overview of a multidisciplinary pain management approach for pediatric patients with acute and chronic pain, (2) highlight the mechanisms of action and evidence base of commonly utilized integrative non-pharmacological therapies in pediatric multidisciplinary pain management, and (3) explore the opioid sparing effects of multidisciplinary treatment for pediatric pain.
阿片类药物疗法是急性手术疼痛和术后疼痛治疗的基石,并且经常被用于治疗严重的慢性疼痛病症。尽管对许多患者有益,但阿片类药物疗法可能会有副作用、疗效有限以及潜在的负面后果。已证明,结合药物治疗和综合非药物治疗的多学科疼痛管理疗法对儿童群体的急性和慢性疼痛管理有效。多学科方法还可以改善心理功能和生活质量,并且可能有减少对阿片类药物依赖的潜力。本文的目的是:(1)简要概述针对患有急性和慢性疼痛的儿科患者的多学科疼痛管理方法,(2)强调儿科多学科疼痛管理中常用的综合非药物疗法的作用机制和证据基础,以及(3)探讨多学科治疗对儿科疼痛的阿片类药物节省效应。