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Evaluation and management of pain in children

Authors
Julie Hauer, MD
Barbara L Jones, PhD, MSW
Section Editor
David G Poplack, MD
Deputy Editor
Carrie Armsby, MD, MPH

INTRODUCTION

Assessment and management of pain are essential components of pediatric care. In children, especially young children, it can be challenging to identify the presence and severity of pain, and then to treat the pain. The use of assessment tools based upon cognitive ability is important to ensure that children of all ages receive adequate pain control.

Assessment of pain and an overview of pain management in children will be reviewed here. Assessment and pain management in the neonate are discussed separately. (See "Assessment of neonatal pain" and "Prevention and treatment of neonatal pain".)

EVALUATION

The evaluation of pediatric pain includes determining the underlying type, source and location, and severity of pain.

Types of pain — Pain is defined as an unpleasant somatic or visceral sensation associated with actual, potential, or perceived tissue damage. It is classified into nociceptive and neuropathic pain based upon the underlying pathophysiology. Determining the type of pain helps in identifying the cause of pain, which may guide treatment choices. (See "Assessment of cancer pain", section on 'Inferred pathophysiology (types of cancer pain)'.)

Nociceptive pain is caused by stimulation of intact nociceptors as a result of tissue injury and inflammation (figure 1). It is divided into somatic pain with receptors in skin, soft tissue, skeletal muscle, and bone; and visceral pain with receptors in internal organs, such as the kidney and gastrointestinal tract. Somatic pain is well localized and described as sharp, aching, squeezing, stabbing, or throbbing. Visceral pain is typically poorly localized, and is often described as dull, crampy, or achy.

                            

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Literature review current through: Nov 2016. | This topic last updated: Tue Sep 29 00:00:00 GMT+00:00 2015.
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