Sansone Lorenzo, Gentile Cristina, Grasso Eleonora Agata, Di Ludovico Armando, La Bella Saverio, Chiarelli Francesco, Breda Luciana
Department of Pediatrics, University "G. D'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy.
Children (Basel). 2023 Jul 13;10(7):1212. doi: 10.3390/children10071212.
Pain is the most common complaint reported by children who access the emergency departments, but despite its frequency and the availability of many international guidelines, it often remains underreported and undertreated. Recently, the American Academy of Pediatrics and the American Pain Society have reiterated the importance of a multidisciplinary approach in order to eliminate pain in children. In all pediatric settings, an adequate assessment is the initial stage in a proper clinical approach to pain, especially in the emergency departments; therefore, an increasing number of age-related tools have been validated. A wide range of analgesic agents are currently available for pain management, and they should be tailored according to the patient's age, the drug's pharmacokinetics and the intensity of pain. In order to facilitate the choice of the appropriate drug, a treatment algorithm based on a ladder approach can be used. Moreover, non-pharmacological techniques should be considered to alleviate anxiety and distress in pediatric age. This review aims to offer a simple but intuitive description of the best strategies for pain relief in children, starting with the prompt recognition and quantification of pain through adequate assessment scales, and following with the identification of the most appropriate therapeutic choice among the ones available for pediatric age.
疼痛是前往急诊科就诊的儿童最常见的主诉，但尽管其很常见且有许多国际指南可供参考，疼痛往往仍未得到充分报告和治疗。最近，美国儿科学会和美国疼痛协会重申了多学科方法对于消除儿童疼痛的重要性。在所有儿科环境中，充分评估是对疼痛采取正确临床方法的初始阶段，尤其是在急诊科；因此，越来越多与年龄相关的工具得到了验证。目前有多种镇痛药物可用于疼痛管理，应根据患者年龄、药物的药代动力学和疼痛强度进行调整。为了便于选择合适的药物，可以使用基于阶梯式方法的治疗算法。此外，应考虑采用非药物技术来缓解儿童的焦虑和痛苦。本综述旨在提供一种简单而直观的描述，介绍儿童疼痛缓解的最佳策略，首先通过适当的评估量表迅速识别和量化疼痛，然后在适用于儿童的治疗方法中确定最合适的治疗选择。
