Pain treatment in children

Abstract

Differences in anatomy, physiology and psychology between children and adults make paediatric pain treatment specific. Acute and chronic pain, malignant and non-malignant chronic pain, nociceptive and neuropathic pain also occur in childhood. The intensity of pain is measured by using scales appropriate for a child’s age and cognitive development. Acute pain in children has a protective function and its assessment is easy in emergency departments, and in postoperative, invasive diagnostic and therapeutic settings. The origin of chronic paediatric pain is both malignant and non-malignant; the latter has somatic, visceral and neuropathic components, originating from tumour progression and chemo-and irradiation therapy. Malignant pain is treated in line with the WHO’s three-step model, with titration, rotation and conversion of opioids. Chronic non-malignant pain includes musculoskeletal pain, tension and migrainous headaches, and neuropathic pain of different origins. Pharmacological and non-pharmacological pain treatment in children is based on pre-emptive and multimodal principles of therapy.