Pain
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Research on the assessment and management of pain in infants and children has increased dramatically, with the consequence that a wide variety of behavioral, physiological, and psychological methods are now available for measuring pediatric pain. Although the criteria for a pain measure for children are identical to those required for any measuring instrument, special problems exist in pediatric pain measurement because the influence of developmental factors, previous pain experience, and parental attitudes on children's perceptions and expressions of pain is not known. This article reviews the recent advances in the measurement of pain in children, with special emphasis on the methods that satisfy the criteria for reliability and validity, the methods that can be used to assess multiple dimensions of pain, and the methods that may be appropriate for assessing all types of acute, recurrent, and chronic pediatric pain.
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A retrospective, multi-physician survey was carried out to examine the infusion concentrations of morphine delivered intrathecally by continuous infusion pumps placed to control pain. Replies from 19 physicians formed the basis for a population of 163 patients who received morphine by continuous infusion delivered by an Infusaid pump through a chronically implanted intrathecal catheter (N = 130 for pain of a metastatic origin; N = 3 for non-metastatic pain; N = 30 undefined). These patients received a total of 3443 patient weeks of infusion. ⋯ E. M.). Though the group morphine utilization rose, examination of the patient population which was infused for periods in excess of 3 months indicated that 48% showed less than a 2-fold increase in dose by 3 months.