Liebelt E L
Yale University School of Medicine, Yale-New Haven Hospital, CT 06504, USA.
Curr Opin Pediatr. 1996 Oct;8(5):436-41. doi: 10.1097/00008480-199610000-00003.
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.
人们越来越关注儿童疼痛的识别、评估和管理。儿童在不同的临床环境中会经历许多痛苦的程序，并且他们的疼痛常常得不到充分治疗。儿科医生应该熟悉有关儿童疼痛感知的一般概念。已经开发并重新构建了许多疼痛评估工具，为临床医生提供有效且可靠的量表，以评估儿童的疼痛并评估干预措施的效果。用于清醒镇静的新型药物制剂在儿科门诊环境中越来越频繁地使用，以减轻疼痛和焦虑。此外，对于曾经需要全身麻醉的手术，区域麻醉技术的使用也越来越多。局部麻醉剂的开发以及对注射用局部麻醉剂的改良也在增加，以减轻局部浸润的疼痛。正在对疼痛管理的非药物方法进行测试、开发，并单独使用或作为接受痛苦程序儿童药物治疗的辅助手段。临床医生必须了解有关疼痛治疗的新进展，并将其纳入实践中。
