The Assessment and Management of Acute Pain in Infants, Children, and Adolescents

TLDR

Acute pain is a frequent adverse stimulus in children, linked to anxiety, avoidance, somatic symptoms, and parental distress, yet it is often inadequately assessed and treated because of myths, caregiver knowledge gaps, and the multifactorial nature of pain involving physiological, psychological, behavioral, developmental, and situational factors. Pediatricians must eliminate or alleviate pain and suffering in children when possible. Pediatricians should expand knowledge, employ appropriate assessment tools, anticipate and intervene in painful events, use multimodal and multidisciplinary pain management, involve families, and advocate for effective pain care.

Abstract

Acute pain is one of the most common adverse stimuli experienced by children, occurring as a result of injury, illness, and necessary medical procedures. It is associated with increased anxiety, avoidance, somatic symptoms, and increased parent distress. Despite the magnitude of effects that acute pain can have on a child, it is often inadequately assessed and treated. Numerous myths, insufficient knowledge among caregivers, and inadequate application of knowledge contribute to the lack of effective management. The pediatric acute pain experience involves the interaction of physiologic, psychologic, behavioral, developmental, and situational factors. Pain is an inherently subjective multifactorial experience and should be assessed and treated as such. Pediatricians are responsible for eliminating or assuaging pain and suffering in children when possible. To accomplish this, pediatricians need to expand their knowledge, use appropriate assessment tools and techniques, anticipate painful experiences and intervene accordingly, use a multimodal approach to pain management, use a multidisciplinary approach when possible, involve families, and advocate for the use of effective pain management in children.