chapter  3
28 Pages

The pharmacological management of paediatric procedure-related cancer pain

WithRichard Hain

This extraordinary view was expressed in the early 1990s by a professor of paediatric haematology (now deceased) at a large tertiary referral centre in North America. As he said it, he would smile in a way that suggested that he realised that what he was saying was controversial and that he might ^ only might ^ be joking. He may genuinely have been joking. However, the view he was

expressing is one that was genuinely held for many years. Scienti¢cally, its roots can perhaps be traced back to a study conducted in 1941,1

which consisted of a series of short ¢lms of the response of children to being pricked by a pin. The study began with the children as newborns and continued to ¢lm them at intervals until they were 4 years old. From observation of the changing pattern of physical response to the procedure as the child developed, the authors concluded that the brain of the very young child was anatomically and physiologically incapable of experiencing pain. Even when fully awake, suggested the authors, children are as insensitive to pain as if they are deeply anaesthetised.