References

Pain in infants, children, and adolescents an overview. In Schechter NL, Berde CB, Yaster M, eds. Pain in Infants, Children, and Adolescents, 2nd ed. Philadelphia Lippincott, Williams, and Wilkins 2003, pp. 3-18. 2. Anand KJS, Sippell WG, Aynsley-Green A. Randomized trial of fentanyl anesthesia in preterm babies undergoing surgery effects on stress response. Lancet 1987 1 243-248. 3. Goldschneider KR, Anand KJS. Long term consequences of pain in neonates. In...

Perioperative Pain

Perioperative pain management should address the preoperative, intraoperative, and postoperative phases for comprehensive intervention and the best attempt to limit the unpleasantness of the surgical pain experience. The management of postoperative pain begins in the preoperative period. The degree of postoperative pain is somewhat influenced by the level of preoperative anticipatory distress (55). Open discussion of expectations of the family and child for the postoperative period should be...

Principles of Pediatric Pain Management

Tenets of good pain management for children are as follows First, give medications by the clock. Around-the-clock administration ensures consistent plasma levels. As-needed (prn, pro re nata) administration has been interpreted by staff to mean as little as possible. Suboptimal dosing by 25 as-needed scheduling has been documented in adults (44). Second, give by the oral route when possible. Novel routes to consider are sublingual, rectal, intranasal, inhalational, and subcutaneous...

Changing Therapeutics in the Management of Intractable Pain in Children at the End of Life 19952005

Pain that cannot be alleviated using conventional treatment is intractable. Intractable pain that does not respond to therapies beyond conventional practice is refractory. The relief of refractory pain may require a therapy that reduces conscious awareness. Intractable pain in childhood is unusual and is mostly seen in the setting of cancer pain and at the end of life. Intractable childhood cancer pain is usually disease related. Disease-related pain often recurs at the time of tumor recurrence...