Pediatrician
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This paper describes methods of assessment and pharmacologic management for chronic or persistent pain in children. This report will be a clinical one, derived from the experiences of a pediatric oncologist (P. M. ⋯ K. Z.). Case reports will illustrate clinical assessment and management strategies.
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This paper provides an overview to the assessment and management of chronic and recurrent pain in children with chronic diseases. Relevant clinical research studies are cited, and practical guidelines are provided for the differential assessment and management issues inherent in the comprehensive care of chronic and recurrent pain in children and adolescents with hemophilia, juvenile rheumatoid arthritis, sickle cell disease, and cancer.
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As the child's primary caretaker, the parents' role in the management of pediatric pain is one of a priori significance, although it has not been studied in a systematic manner. This article considers several domains in which the parent may influence the onset and course of pediatric pain problems, as well as ways in which the parent may assist in pain assessment and management. ⋯ The parents' role in pediatric pain management is considered in terms of the interactive effects of parent and child distress, and avenues for direct parental intervention. It is concluded that the parent can be a helpful agent to the pediatrician in treating children's pain problems, while enhancing the parents' feelings of usefulness and competency in the process.
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Children are ideal patients for outpatient surgery. Thorough preoperative medical evaluation and selection of appropriate surgical and anesthetic procedures allow most pediatric surgery to be performed safely on an outpatient basis. ⋯ Good anesthetic management consists of selecting anesthetic agents and techniques to promote safety, minimize complications, reduce postoperative nausea, vomiting and pain, and facilitate recovery and discharge. Most importantly, the outpatient setting permits minimal disruption of a child's life and provides an opportunity for the pediatric patient and family to have a positive health-care experience while receiving necessary surgical care.
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Review Clinical Trial
Assessment and management of postoperative pain in children.
This paper focuses on the knowledge base about the assessment and management of postoperative pain in children. The first section deals with the nature and characteristics of postoperative pain. A description of current pain management practices with children, focusing on analgesic administration, is derived from available research literature. ⋯ Recent advances in pain assessment and measurement in all age groups, particularly with verbal children and the new self-report measures, are discussed. The latest developments in pharmacological and nonpharmacological techniques for the relief of children's postoperative pain are also described. Finally, the paper concludes with a few suggestions for pediatricians relative to their role in assisting in the search for better assessment and management techniques in the care of postoperative children.