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The Impetus for Recognizing, Preventing, and Treating Pain in the Pediatric Population

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Opioid Therapy in Infants, Children, and Adolescents

Abstract

Historically, the medical community believed that young children did not feel pain the same way as adults or form long-term memories of it due to their immature pain pathways. Over the past 30 years, we have gained a much better understanding of how infants and children respond to tissue injury and perceive pain. There is now a greater appreciation of the plasticity of the developing infant nociceptive system. Evidence is emerging that untreated pain suffered early in life can have profound and long-lasting consequences on the nervous system that affect how pain is perceived later in life. Inadequate pain management in children can contribute to poor health outcomes, increased opioid use, and can lead to development of chronic pain. It is crucial that children receive optimal multimodal pain management early in life in order to diminish or prevent the negative long-term consequence of pain.

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References

  1. Groenewald CB, Law EF, Fisher E, Beals-Erickson SE, Palermo TM. Associations between adolescent chronic pain and prescription opioid misuse in adulthood. J Pain. 2018; https://doi.org/10.1016/j.jpain.2018.07.007.

    Article  PubMed  Google Scholar 

  2. Walker LS, Sherman AL, Bruehl S, Garber J, Smith CA. Functional abdominal pain patient subtypes in childhood predict functional gastrointestinal disorders with chronic pain and psychiatric comorbidities in adolescence and adulthood. Pain. 2012;153:1798–806. https://doi.org/10.1016/j.pain.2012.03.026.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Dion D. Pain in Canada fact sheet: pain is poorly managed in Canada. 2014.

    Google Scholar 

  4. Swafford Ll AD. Pain relief in pediatric patient. Med Clin N Am. 1968;52:131–6.

    Article  Google Scholar 

  5. Beyer JE, DeGood DE, Ashley LC, Russell GA. Patterns of postoperative analgesic use with adults and children following cardiac surgery. Pain. 1983;17:71–81.

    Article  CAS  PubMed  Google Scholar 

  6. Rovner S. Surgery without anesthesia: can premies feel pain? 1986.

    Google Scholar 

  7. Anand KJ, Hansen DD, Hickey PR. Hormonal-metabolic stress responses in neonates undergoing cardiac surgery. Anesthesiology. 1990;73:661–70.

    Article  CAS  PubMed  Google Scholar 

  8. Anand KJ, Sippell WG, Aynsley-Green A. Randomised trial of fentanyl anaesthesia in preterm babies undergoing surgery: effects on the stress response. Lancet (London, England). 1987;1:243–8.

    Article  CAS  Google Scholar 

  9. Anand KJ, Hickey PR. Halothane-morphine compared with high-dose sufentanil for anesthesia and postoperative analgesia in neonatal cardiac surgery. N Engl J Med. 1992;326:1–9. https://doi.org/10.1056/nejm199201023260101.

    Article  CAS  PubMed  Google Scholar 

  10. Blencowe H, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet (London, England). 2012;379:2162–72. https://doi.org/10.1016/s0140-6736(12)60820-4.

    Article  Google Scholar 

  11. Carbajal R, et al. Epidemiology and treatment of painful procedures in neonates in intensive care units. JAMA. 2008;300:60–70. https://doi.org/10.1001/jama.300.1.60.

    Article  CAS  PubMed  Google Scholar 

  12. Johnston C, Barrington KJ, Taddio A, Carbajal R, Filion F. Pain in Canadian NICUs: have we improved over the past 12 years? Clin J Pain. 2011;27:225–32. https://doi.org/10.1097/AJP.0b013e3181fe14cf.

    Article  PubMed  Google Scholar 

  13. Fitzgerald M. The development of nociceptive circuits. Nat Rev Neurosci. 2005;6:507–20. https://doi.org/10.1038/nrn1701.

    Article  CAS  PubMed  Google Scholar 

  14. McGrath P. Children-not simply “little adults”. In: Merskey HLJ, Dubner R, editors. The paths of pain. Seattle: IASP Press; 2005. p. 433–46.

    Google Scholar 

  15. Boucher T, Jennings E, Fitzgerald M. The onset of diffuse noxious inhibitory controls in postnatal rat pups: a C-Fos study. Neurosci Lett. 1998;257:9–12.

    Article  CAS  PubMed  Google Scholar 

  16. Kaas JH, Merzenich MM, Killackey HP. The reorganization of somatosensory cortex following peripheral nerve damage in adult and developing mammals. Annu Rev Neurosci. 1983;6:325–56. https://doi.org/10.1146/annurev.ne.06.030183.001545.

    Article  CAS  PubMed  Google Scholar 

  17. Allegaert K, Devlieger H, Bulckaert D, Naulaers G, Casaer P, Tibboel D. Variability in pain expression characteristics in former preterm infants. J Perinat Med. 2005;33:442–8. https://doi.org/10.1515/jpm.2005.078.

    Article  PubMed  Google Scholar 

  18. Peters JW, Schouw R, Anand KJ, van Dijk M, Duivenvoorden HJ, Tibboel D. Does neonatal surgery lead to increased pain sensitivity in later childhood? Pain. 2005;114:444–54. https://doi.org/10.1016/j.pain.2005.01.014.

    Article  PubMed  Google Scholar 

  19. Grunau RE, et al. Neonatal pain, parenting stress and interaction, in relation to cognitive and motor development at 8 and 18 months in preterm infants. Pain. 2009;143:138–46. https://doi.org/10.1016/j.pain.2009.02.014.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Grunau RE, Haley DW, Whitfield MF, Weinberg J, Yu W, Thiessen P. Altered basal cortisol levels at 3, 6, 8 and 18 months in infants born at extremely low gestational age. J Pediatr. 2007;150:151–6. https://doi.org/10.1016/j.jpeds.2006.10.053.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Brummelte S, et al. Procedural pain and brain development in premature newborns. Ann Neurol. 2012;71:385–96. https://doi.org/10.1002/ana.22267.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Duerden EG, et al. Early procedural pain is associated with regionally-specific alterations in thalamic development in preterm neonates. J Neurosci. 2018;38:878–86. https://doi.org/10.1523/jneurosci.0867-17.2017.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Taylor EM, Boyer K, Campbell FA. Pain in hospitalized children: a prospective cross-sectional survey of pain prevalence, intensity, assessment and management in a Canadian pediatric teaching hospital. Pain Res Manag. 2008;13:25–32.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Ammentorp J, Mainz J, Sabroe S. Parents’ priorities and satisfaction with acute pediatric care. Arch Pediatr Adolesc Med. 2005;159:127–31. https://doi.org/10.1001/archpedi.159.2.127.

    Article  PubMed  Google Scholar 

  25. Taddio A, Katz J, Ilersich AL, Koren G. Effect of neonatal circumcision on pain response during subsequent routine vaccination. Lancet (London, England). 1997;349:599–603. https://doi.org/10.1016/s0140-6736(96)10316-0.

    Article  CAS  Google Scholar 

  26. Weisman SJ, Bernstein B, Schechter NL. Consequences of inadequate analgesia during painful procedures in children. Arch Pediatr Adolesc Med. 1998;152:147–9.

    Article  CAS  PubMed  Google Scholar 

  27. Wollgarten-Hadamek I, Hohmeister J, Zohsel K, Flor H, Hermann C. Do school-aged children with burn injuries during infancy show stress-induced activation of pain inhibitory mechanisms? Eur J Pain (London, England). 2011;15:423.e1–10. https://doi.org/10.1016/j.ejpain.2010.09.001.

    Article  Google Scholar 

  28. Breakey VR, Pirie J, Goldman RD. Pediatric and emergency medicine residents’ attitudes and practices for analgesia and sedation during lumbar puncture in pediatric patients. Pediatrics. 2007;119:e631–6. https://doi.org/10.1542/peds.2006-0727.

    Article  PubMed  Google Scholar 

  29. Stevens BJ, et al. Epidemiology and management of painful procedures in children in Canadian hospitals. CMAJ. 2011;183:E403–10. https://doi.org/10.1503/cmaj.101341.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Perquin CW, Hazebroek-Kampschreur AA, Hunfeld JA, Bohnen AM, van Suijlekom-Smit LW, Passchier J, van der Wouden JC. Pain in children and adolescents: a common experience. Pain. 2000;87:51–8.

    Article  CAS  PubMed  Google Scholar 

  31. Roth-Isigkeit A, Thyen U, Raspe HH, Stoven H, Schmucker P. Reports of pain among German children and adolescents: an epidemiological study. Acta Paediatr (Oslo, Norway: 1992). 2004;93:258–63.

    Article  Google Scholar 

  32. Groenewald CB, Essner BS, Wright D, Fesinmeyer MD, Palermo TM. The economic costs of chronic pain among a cohort of treatment-seeking adolescents in the United States. J Pain. 2014;15:925–33. https://doi.org/10.1016/j.jpain.2014.06.002.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Hunfeld JA, Perquin CW, Duivenvoorden HJ, Hazebroek-Kampschreur AA, Passchier J, van Suijlekom-Smit LW, van der Wouden JC. Chronic pain and its impact on quality of life in adolescents and their families. J Pediatr Psychol. 2001;26:145–53.

    Article  CAS  PubMed  Google Scholar 

  34. Dampier C, Ely B, Brodecki D, O’Neal P. Characteristics of pain managed at home in children and adolescents with sickle cell disease by using diary self-reports. J Pain. 2002;3:461–70.

    Article  PubMed  Google Scholar 

  35. Schanberg LE, Anthony KK, Gil KM, Maurin EC. Daily pain and symptoms in children with polyarticular arthritis. Arthritis Rheum. 2003;48:1390–7. https://doi.org/10.1002/art.10986.

    Article  PubMed  Google Scholar 

  36. Ljungman G, Gordh T, Sorensen S, Kreuger A. Pain variations during cancer treatment in children: a descriptive survey. Pediatr Hematol Oncol. 2000;17:211–21. https://doi.org/10.1080/088800100276389.

    Article  CAS  PubMed  Google Scholar 

  37. Goldman A, Hewitt M, Collins GS, Childs M, Hain R. Symptoms in children/young people with progressive malignant disease: United Kingdom Children’s Cancer Study Group/Paediatric Oncology Nurses Forum survey. Pediatrics. 2006;117:e1179–86. https://doi.org/10.1542/peds.2005-0683.

    Article  PubMed  Google Scholar 

  38. Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011;152(3 Suppl):S2–15.

    Article  PubMed  Google Scholar 

  39. Walker LS, Dengler-Crish CM, Rippel S, Bruehl S. Functional abdominal pain in childhood and adolescence increases risk for chronic pain in adulthood. Pain. 2010;150:568–72. https://doi.org/10.1016/j.pain.2010.06.018.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Hassett AL, Hilliard PE, Goesling J, Clauw DJ, Harte SE, Brummett CM. Reports of chronic pain in childhood and adolescence among patients at a tertiary care pain clinic. J Pain. 2013;14:1390–7. https://doi.org/10.1016/j.jpain.2013.06.010.

    Article  PubMed  Google Scholar 

  41. Watt-Watson J, et al. A survey of prelicensure pain curricula in health science faculties in Canadian universities. Pain Res Manag. 2009;14:439–44. 152:S2–15. https://doi.org/10.1016/j.pain.2010.09.030.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada

    Naiyi Sun & Fiona Campbell

Authors
  1. Naiyi Sun
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  2. Fiona Campbell
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Correspondence to Naiyi Sun .

Editor information

Editors and Affiliations

  1. Department of Pediatric Anesthesiology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Ravi D. Shah

  2. Department of Pediatric Anesthesiology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Santhanam Suresh

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Sun, N., Campbell, F. (2020). The Impetus for Recognizing, Preventing, and Treating Pain in the Pediatric Population. In: Shah, R., Suresh, S. (eds) Opioid Therapy in Infants, Children, and Adolescents. Springer, Cham. https://doi.org/10.1007/978-3-030-36287-4_4

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  • DOI: https://doi.org/10.1007/978-3-030-36287-4_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-36286-7

  • Online ISBN: 978-3-030-36287-4

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