Procedural pain

In all age groups, pain is a clinical symptom that disrupts the quality of life. Pain according to the International Association for the Study of Pain; It is defined as "sensorial, unpleasant, emotional sensation and behavior related to the subjective, primitive protective experience of the human being in the past, whether or not connected to a strong tissue destruction, originating from a specific region of the body".

 

As in adults, patients in the pediatric age group are also susceptible to painful interventions. However, it is also known that these patients are inadequate in approaching pain. It is suggested that the most important reason for these inadequacies is the treatment of wrong ideas among clinicians. These are the fact that the neonatal nervous system does not feel pain due to immobilization, the severity of pain in children and the use of opioids have a higher dependency potency. Acute pain is an important problem as children have various chronic pain syndromes. Particularly posttraumatic and interventional acute pain is an important problem in the emergency department and in the intensive care unit.

 

 

In adults, the measurement of pain and responses to pain have been studied more. However, recent studies have shown that pediatric age groups also have similar physiological and behavioral changes in adults. Children respond to different severe painful stimuli in parallel to adults.

 

Nonpharmacologic and pharmacological methods can be used in the approach of pediatric acute pain. Nonpharmacologic methods are mostly approaches to reduce environmental stress and facilitate child's compliance with treatment.

 

Pharmacological pain therapy is the practice of suppressing the nociceptive stimulation and making the procedure comfortable for both the patient and the physician. These applications range from the application of topical local anesthetics to complex approaches such as sedative, analgesic, and regional blocks. In order to perform these applications, it is important to evaluate and monitor the anatomical and physiological parameters of the patient.

 

 

Various agents used in general anesthesia can be used in sedative and analgesic approaches. In addition to opioids such as morphine, fentanyl and meperidine, hypnotic agents such as diazepam, midazolam, ketamine, nitrous oxide, propofol and etomidate have also found application. In the use of these agents, it is important to ensure that there is absolutely good monitoring in terms of patient safety, as well as the availability of equipment for the control of the airways at any time. In addition, follow-up of sedated patients should be done carefully.

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Prof. Dr. Altan Şahin, 2018