ABSTRACT
Adequate treatment of pain is an acknowledged basic human right. However, many children, especially the youngest and most immature, are potentially denied the best available treatment due to inadequate education of their caregivers. Safe pain management in children can be difficult, as significant background knowledge is required, and developmental age has a profound effect on both the processing of nociceptive information and the response to analgesia. In addition, changing body size, body composition and immaturity of excretory systems alters drug disposition, requires dosage adjustments for both size and age, and can predispose to toxicity and side-effects. Communication difficulties due to immaturity or developmental delay also influence our ability to assess pain and the response to treatment, thereby further complicating management, particularly in the very young. These factors have contributed to the frequently documented relative under-treatment of pain in children,
Introduction 407 Pain neurophysiology 407 Development of nociception and the response to injury 409 Assessment of pain 410 Principles of pain management 412
Non-pharmacological approaches to pain management 414 Pain management teams 414 Acute postoperative pain 414 Management of chronic and long-term pain 419 References 421
and have led to misunderstandings about the ability of newborn infants to feel pain.
