Pfefferbaum B, Hagberg C A
Department of Psychiatry and Behavioral Sciences, University of Oklahoma College of Medicine, Norman.
J Am Acad Child Adolesc Psychiatry. 1993 Mar;32(2):235-42. doi: 10.1097/00004583-199303000-00001.
This article examines the use of analgesics and psychopharmacological adjuvants in children experiencing pain. Peripheral analgesics are effective for mild to moderate pain. Narcotics are effective but may produce dependence and tolerance as well as untoward side effects. Major tranquilizers, minor tranquilizers, tricyclic antidepressants, and stimulants have all been used as adjuvants in pain management. Major tranquilizers are now discouraged because of potential serious adverse effects. Benzodiazepines are relatively safe and decrease anxiety accompanying pain. Tricyclics may be used with caution. Stimulants have received little attention but may be useful in treating both pain and depression in the physically ill.
本文探讨了镇痛药和精神药理学辅助药物在儿童疼痛治疗中的应用。外周镇痛药对轻至中度疼痛有效。麻醉药有效，但可能产生依赖性、耐受性以及不良副作用。大剂量镇静剂、小剂量镇静剂、三环类抗抑郁药和兴奋剂都曾被用作疼痛管理的辅助药物。由于潜在的严重不良反应，现在不鼓励使用大剂量镇静剂。苯二氮䓬类药物相对安全，可减轻伴随疼痛的焦虑。三环类药物使用时需谨慎。兴奋剂很少受到关注，但可能有助于治疗身体疾病患者的疼痛和抑郁。
