Reducing pain during procedures.

There is an increasing focus on the recognition, assessment, and management of pain in children. Children undergo many painful procedures in different clinical environments and are frequently undertreated for their pain. The pediatrician should be familiar with general concepts about the perception of pain in children. Many pain-assessment tools have been developed and restructured to provide the clinician with valid and reliable scales to assess pain in children and assess the effect of interventions. New pharmacologic agents for conscious sedation are being used with increasing frequency in the pediatric outpatient setting for reducing pain and anxiety. Also there has been increasing use of regional anesthetic techniques for procedures once requiring general anesthesia. There has been an increase in the development of topical anesthetics as well as modifying injectable local anesthetic to decrease the pain of local infiltration. Nonpharmacologic methods of pain management are being tested, developed, and used alone or as adjuncts to pharmacologic therapy for children undergoing painful procedures. It is imperative that clinicians keep themselves informed about new advances pertaining to pain treatment and incorporate them into their practices.