Pediatric Pain Management
Abstract 2005 MHE Conference
Ashish Sinha
Department of Anesthesiology & Critical School of Medicine
University of Pennsylvania, Philadelphia PA 19104-4283
Pain in the pediatric patients is frequently under treated due to a variety of factors. From under
recognition of the pain itself to myths that children do not feel as much pain as adults, because of
immature peripheral and central nervous systems. Part of the problem is the mistaken belief that
pain is less harmful than the side effects of analgesic therapy. Lack of awareness of treatment
options and ignorance of analgesic pharmacology in children compound this problem.
Pain assessment in children has been mandated by JCAHO and frequently referred to as the 5th vital
sign. The need for accurate pain assessment is essential for accurate pain management.\
Sometimes this is an approximation because of limited verbal communication in the younger children
population. Multiple reasons contribute to the denial of pain by children. Useful tools for pediatric
pain assessment, depending on the age of the child, include CRIES, FLACC, Wong Baker faces scale
and VAS (Visual Analog Scale) scores.
Treatment of chronic pain is handled differently than that of acute pain in children. Pain treatment in
the setting of chronic pain in children is multimodal as in adults and has components of depression
that should be addressed appropriately. The concept of the WHO pain ladder being applied to
children is consistent with appropriate and responsible pain management.
Pain that arises in the musculoskeletal system has issues with reluctant limb usage with its attendant
problems, of dystrophy and atrophy. An expert in physical therapy should be involved in the
handling of these issues.
Abstract 2005 MHE Conference
Ashish Sinha
Department of Anesthesiology & Critical School of Medicine
University of Pennsylvania, Philadelphia PA 19104-4283
Pain in the pediatric patients is frequently under treated due to a variety of factors. From under
recognition of the pain itself to myths that children do not feel as much pain as adults, because of
immature peripheral and central nervous systems. Part of the problem is the mistaken belief that
pain is less harmful than the side effects of analgesic therapy. Lack of awareness of treatment
options and ignorance of analgesic pharmacology in children compound this problem.
Pain assessment in children has been mandated by JCAHO and frequently referred to as the 5th vital
sign. The need for accurate pain assessment is essential for accurate pain management.\
Sometimes this is an approximation because of limited verbal communication in the younger children
population. Multiple reasons contribute to the denial of pain by children. Useful tools for pediatric
pain assessment, depending on the age of the child, include CRIES, FLACC, Wong Baker faces scale
and VAS (Visual Analog Scale) scores.
Treatment of chronic pain is handled differently than that of acute pain in children. Pain treatment in
the setting of chronic pain in children is multimodal as in adults and has components of depression
that should be addressed appropriately. The concept of the WHO pain ladder being applied to
children is consistent with appropriate and responsible pain management.
Pain that arises in the musculoskeletal system has issues with reluctant limb usage with its attendant
problems, of dystrophy and atrophy. An expert in physical therapy should be involved in the
handling of these issues.
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| Dr. Ashish Sinha |
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National Library of Medicine, Directory of Health Organizations (SIS) website, as well as the link for Patient
Information on The Diseases Database a cross-referenced index of human disease, and the Intute: health & life
sciences a free online service providing access to the very best Web resources for education and research
located in the UK
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