Pain and sedation

Pain is amongst the most frequently occurring problems anaesthetists are confronted with in paediatric clinical settings and can be due to trauma, illness, surgery, or procedures. It remains one of the most challenging issues that clinicians have to manage during hospital admission. Despite the significant strides made over the last 30 years, pain management practices continue to fall short of exemplary and children continue to experience needless moderate to severe pain in hospital. ‘Child’ refers to any individual between birth and eighteen years of age. Within this age range there are broad variations in cognitive, physical and socio-emotional development that significantly impact and influence pain assessment and pain management strategies. Effective pain management requires adaptation and tailoring of treatment strategies for each individual rather than a rigid application of formulae, and while it is not always possible or feasible to eradicate all pain, practitioners should endeavour to reduce it to a tolerable level. This chapter aims to provide trainees with a highly practical and easy-to-access overview of pain management strategies that are appropriate and effective. It contain core information that will enable anaesthetic trainees to identify the most appropriate pain management therapies for paediatric patients. The information presented is brief and succinct, providing an essential up-to-date, rational, and logical approach to pain management in children.