[Halima Ali]

#95347

The problem of under-treatment of paediatric patients’ pain is still widely considered to be a clinical and ethical dilemma of great importance. Misunderstandings regarding children’s ability to feel or recall pain, as well as the fear of opioid addiction and respiratory depression, have all played their part in the history of inadequate pain control.

The impact of this situation is far from negligible. Pain that is not properly managed causes suffering that is not only physical but also mental; it may even result in someone becoming a patient for life with all sorts of pain related to the previous medical procedures (hyperalgesia, chronic pain, or even a dissociation-like condition called PTSD). In the case of infants, pain untreated can alter the brain and the nervous system’s development, resulting in delays in these areas.

The answer to pain management lies in a comprehensive approach. The first thing to do is to routinely apply the pain assessment tools that have been validated for the age of the child, thus allowing for the objective evaluation of the child’s distress. The second point is to adopt a proactive and preventive approach which is a must, especially in the case of surgeries and other invasive procedures. The strategy consists of pharmacological approaches as well as non-pharmacological techniques.

The range of drug options starts from over-the-counter pain relievers such as acetaminophen and ibuprofen for milder discomfort, proceeding to local anesthetics, sedatives, and opioids under strict medical supervision for the most severe cases. All the same, it is important to recognize that non-drug interventions can be very effective and even indispensable. These techniques include breastfeeding or using sucrose solution for infants, using distraction measures (bubbles, videos) among others, and care positioning plus a peaceful environment.

In the end, the matter of pain under-treatment is one that requires a big change in attitude from the society. The practitioners in the medical field have to put themselves in the place of children and think of pain as a “vital sign”, they must also debunk the old myths and be the spokespeople for the child’s right to have comfort. A reliable assessment, a swift drug intervention, and a combination of comfort measures are therefore very much necessary for pediatric pain control to be both safe and effective.

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