Intervention and Management

  • Patricia A. McGrath


Interest in the alleviation of children’s pain has increased at an unprecedented rate during the past 5 years (for review, see Barr, 1989; McGrath, 1990; McGrath & Unruh, 1987; Ross & Ross, 1988; Schechter, 1989; Tyler & Krane, 1990). Special attention has been focused on the management of acute pain in infants, recurrent pain in otherwise healthy and pain-free children, and pain caused by repeated medical procedures for children with chronic disease. Both clinical practice and research investigations have shared a dual emphasis: to develop valid, reliable, and practical techniques for evaluating a child’s pain complaint, and then to select the most effective intervention for alleviating his/her pain.


Chronic Pain Sickle Cell Anemia Pain Control Acute Pain Operant Conditioning 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. American Academy of Pediatrics, Committee on Drugs. (1977). Guidelines for the ethical conduct of studies to evaluate drugs in pediatric populations. Pediatrics, 60, 90–101.Google Scholar
  2. American Academy of Pediatrics, Committee on Infectious Diseases. (1982). Special report: Aspirin and Reye’s syndrome. Pediatrics, 69, 810–812.Google Scholar
  3. Attanasio, V., Andrasik, F., Burke, E. J., Blake, D. D., Kabela, E., & McCarran, M. S. (1985). Clinical issues in utilizing biofeedback with children. Clinical Biofeedback and Health, 8, 134–141.Google Scholar
  4. Attia, J., Ecoffey, C., Sandouk, P., Gross, J. B., & Samii, K. (1986). Epidural morphine in children: Pharmacokinetics and CO2 sensitivity. Anesthesiology, 65, 590–594.PubMedCrossRefGoogle Scholar
  5. Bandura, A. (1976). Effecting change through participant modeling. In J. D. Krumboltz & C. E. Thoresen (Eds.), Counseling methods (pp. 248–265). New York: Holt, Rinehart and Winston.Google Scholar
  6. Barr, R. G. (1989). Pain in children. In P. D. Wall & R. Melzack (Eds.), Textbook of pain (2nd Ed., pp. 568–588). Edinburgh: Churchill Livingstone.Google Scholar
  7. Beers, R. F., & Bassett, E. G. (Eds.). (1979). Mechanisms of pain and analgesic compounds. New York: Raven Press.Google Scholar
  8. Benitz, W. E., & Tatro, D. S. (1981). The pediatric drug handbook. Chicago: Year Book Medical.Google Scholar
  9. Benson, H., Pomeranz, B., & Kutz, I. (1984). The relaxation response and pain. In P. D. Wall & R. Melzack (Eds.), Textbook of pain (pp. 817–822). Edinburgh: Churchill Livingstone.Google Scholar
  10. Beyer, J. E., DeGood, D. E., Ashley, L. C., & Russell, G. A. (1983). Patterns of postoperative analgesic use with adults and children following cardiac surgery. Pain, 17, 71–81.PubMedCrossRefGoogle Scholar
  11. Bromage, P. R. (1984). Epidural anaesthetics and narcotics. In P. D. Wall & R. Melzack (Eds.), Textbook of pain (pp. 558–565). Edinburgh: Churchill Livingstone.Google Scholar
  12. Brown, R. E. Jr., & Broadman, L. M. (1987). Patient-controlled analgesia (PCA) for postoperative pain control in adolescents. Anesthesia and Analgesia, 66, S1–S191.CrossRefGoogle Scholar
  13. Cohen, S. N. (1980). Ethics of drug research in children. In S. J. Yaffe (Ed.), Pediatric pharmacology: Therapeutic principles in practice (pp. 93–100). New York: Grune and Stratton.Google Scholar
  14. Cousins, M. M., & Mather, L. E. (1984). Intrathecal and epidural administration of opioids. Anesthesiology, 61, 276–310.PubMedCrossRefGoogle Scholar
  15. Diamond, S. (1979). Biofeedback and headache. Headache, 19, 180–184.PubMedCrossRefGoogle Scholar
  16. Dodd, E., Wang, J. M., & Rauck, R. L. (1988). Patient controlled analgesia for postsurgical pediatric patients ages 6–16 years. Anesthesiology, 69, A372.CrossRefGoogle Scholar
  17. Dubner, R., Hoffman, D. S., & Hayes, R. L. (1981). Neural activity in medullary dorsal horn of awake monkeys trained in a thermal discrimination task: III. Task-related responses and their functional role. Journal of Neurophysiology, 46, 444–464.PubMedGoogle Scholar
  18. Dundee, J. W., & Loan, W. B. (1983). Assessment of analgesic drugs. In N. E. Williams & H. Wilson (Eds.), International encyclopedia of pharmacology and therapeutics: Sec. 112, Pain and its management (pp. 79–88). Elmsford, NY: Pergamon Press.Google Scholar
  19. Eland, J. M. (1974). Children’s communication of pain. Unpublished master’s thesis, University of Iowa.Google Scholar
  20. Ellenberg, L., Kellerman, J., Dash, J., Higgins, G., & Zeltzer, L. (1980). Use of hypnosis for multiple symptoms in an adolescent girl with leukemia. Journal of Adolescent Health Care, 1, 132–136.PubMedCrossRefGoogle Scholar
  21. Finholt, D. A., Stirt, J. A., & DiFazio, C. A. (1985). Epidural morphine for postoperative analgesia in pediatric patients. Anesthesia and Analgesia, 64, 211.Google Scholar
  22. Fordyce, W. E. (1976). Behavioral methods for chronic pain and illness. St. Louis: C. V. Mosby.Google Scholar
  23. Fordyce, W. E. (1978). Learning processes in pain. In R. A. Sternbach (Ed.), The psychology of pain (pp. 49–72). New York: Raven Press.Google Scholar
  24. Fromm, E., & Shor, R. E. (Eds.). (1979). Hypnosis: Developments in research and new perspectives. Chicago: Aldine.Google Scholar
  25. Gladtke, E. (1983). Use of antipyretic analgesics in the pediatric patient. American Journal of Medicine, 75, 121–126.PubMedCrossRefGoogle Scholar
  26. Glenski, J. A., Warner, M. A., Dawson, B., & Kaufman, B. (1984). Postoperative use of epidurally administered morphine in children and adolescents. Mayo Clinic Proceedings, 59, 530–533.PubMedGoogle Scholar
  27. Goodman, L. S., & Gilman, A. G. (Eds.). (1985). The pharmacological basis of therapeutics (7th ed.). New York: Macmillan.Google Scholar
  28. Gross, S. C., & Gardner, G. G. (1980). Child pain: Treatment approaches. In W. L. Smith, H. Merskey, & S. C. Gross (Eds.), Pain: Meaning and management (pp. 127–142). Jamaica, NY: Spectrum Publications.Google Scholar
  29. Gruner, O. C. (1930). A treatise on the Canon of Medicine of Avicenna. London: Luzac.Google Scholar
  30. Hilgard, E. R., & Hilgard, J. R. (1983). Hypnosis in the relief of pain. Los Altos, CA: William Kaufmann.Google Scholar
  31. Hilgard, J. R., & LeBaron, S. (1984). Hypnotherapy of pain in children with cancer. Los Altos, CA: William Kaufmann.Google Scholar
  32. Huskisson, E. C. (1984). Non-narcotic analgesics. In P. D. Wall & R. Melzack (Eds.), Textbook of pain (pp. 505–513). Edinburgh: Churchill Livingstone.Google Scholar
  33. Jacobsen, E. (1938). Progressive relaxation. Chicago: University of Chicago Press.Google Scholar
  34. Jaffe, J. H., & Martin, W. R. (1980). Narcotic analgesics and antagonists. In A. G. Gilman, L. S. Goodman, & A. Gilman (Eds.), The pharmacological basis of therapeutics (pp. 245–283). New York: Macmillan.Google Scholar
  35. Jay, S. M., Elliott, C. H., Ozolins, M., Olson, R. A., & Pruitt, S. D. (1985). Behavioural management of children’s distress during painful medical procedures. Behaviour Research and Therapy, 23, 513–552.PubMedCrossRefGoogle Scholar
  36. Jessup, B. A. (1984). Biofeedback. In P. D. Wall & R. Melzack (Eds.), Textbook of pain (pp. 776–786). Edinburgh: Churchill Livingstone.Google Scholar
  37. Katz, E. R., Kellerman, J., & Ellenberg, L. (1987). Hypnosis in the reduction of acute pain and distress in children with cancer. Journal of Pediatric Psychology, 12, 379–394.PubMedCrossRefGoogle Scholar
  38. Kellerman, J., Zeltzer, L., Ellenberg, L., & Dash, J. (1983). Adolescents with cancer. Hypnosis for the reduction of the acute pain and anxiety associated with medical procedures. Journal of Adolescent Health Care, 4, 85–90.PubMedCrossRefGoogle Scholar
  39. Krane, E. J., Tyler, D. C., & Jacobson, L. J. (1989). The dose response of caudal morphine in children. Anesthesiology, 71, 48–52.PubMedCrossRefGoogle Scholar
  40. LaBaw, W. L. (1973). Adjunctive trance therapy with severely burned children. International Journal of Child Psychotherapy, 2, 80–92.Google Scholar
  41. LaBaw, W. L. (1975). Auto-hypnosis in haemophilia. Haematologia, 9, 103–110.PubMedGoogle Scholar
  42. LaBaw, W. L., Holton, C., Tewell, K., & Eccles, D. (1975). The use of self-hypnosis by children with cancer. American Journal of Clinical Hypnosis, 17, 233–238.PubMedCrossRefGoogle Scholar
  43. Levine, M. N., Sackett, D. L., & Bush, H. (1986). Heroin vs. morphine for cancer pain? Archives of Internal Medicine, 146, 353–356.PubMedCrossRefGoogle Scholar
  44. Masek, B. J., Russo, D. C., & Varni, J. W. (1984). Behavioral approaches to the management of chronic pain in children. Pediatric Clinics of North America, 31, 1113–1131.PubMedGoogle Scholar
  45. Mather, L. E., & Mackie, J. (1983). The incidence of postoperative pain in children. Pain, 15, 271–282.PubMedCrossRefGoogle Scholar
  46. McCaffery, M. (1979). Nursing management of the patient with pain. Philadelphia: J. B. Lippincott.Google Scholar
  47. McCaffery, M., & Beebe, A. (1989). Pain: Clinical manual for nursing practice. St. Louis: C. V. Mosby.Google Scholar
  48. McGrath, P. A. (1990). Pain in children: Nature, assessment and treatment. New York: Guilford.Google Scholar
  49. McGrath, P. A., & deVeber, L. L. (1986). The management of acute pain evoked by medical procedures in children with cancer. Journal of Pain and Symptom Management, 1, 145–150.PubMedCrossRefGoogle Scholar
  50. McGrath, P. J. (1983). Migraine headaches in children and adolescents. In P. Firestone, P. J. McGrath, & W. Feldman (Eds.), Advances in behavioral medicine for children and adolescents (pp. 39–57). Hillsdale, NJ: Erlbaum.Google Scholar
  51. McGrath, P. J., & Unruh, A. (1987). Pain in children and adolescents. Amsterdam: Elsevier.Google Scholar
  52. McIlvaine, W. B. (1990). Spinal opioids for the pediatric patient. Journal of Pain and Symptom Management, 5, 183–190.PubMedCrossRefGoogle Scholar
  53. Means, L. J., Allen, H. M., Lookabill, S. J., & Krishna, G. (1988). Recovery room initiation of patient-controlled analgesia in pediatric patients. Anesthesiology, 69, A772.CrossRefGoogle Scholar
  54. Melamed, B. G., & Siegel, L. J. (1980). Behavioral medicine: practical applications in health care (Vol. 6). New York: Springer.Google Scholar
  55. Melzack, R., & Wall, P. D. (1965). Pain mechanisms: A new theory. Science, 150, 971–978.PubMedCrossRefGoogle Scholar
  56. Moulin, D. E., & Coyle, N. (1986). Spinal opioid analgesics and local anesthetics in the management of chronic cancer pain. Journal of Pain and Symptom Management, 1, 79–86.PubMedCrossRefGoogle Scholar
  57. Olness, K. (1981a). Hypnosis in pediatric practice. Current Problems in Pediatrics, 12, 1–47.PubMedCrossRefGoogle Scholar
  58. Olness, K. (1981b). Imagery (self-hypnosis) as adjunct therapy in childhood cancer: Clinical experience with 25 patients. American Journal of Pediatric Hematology/ Oncology, 3, 313–321.PubMedGoogle Scholar
  59. Olness, K., & MacDonald, J. (1981). Self-hypnosis and biofeedback in the management of juvenile migraine. Journal of Developmental and Behavioral Pediatrics, 2, 168–170.PubMedCrossRefGoogle Scholar
  60. Orne, M. T. (1983). Hypnotic methods for managing pain. In J. Bonica, U. Lindblom, & A. Iggo (Eds.), Advances in pain research and therapy (Vol. 5, pp. 847–856). New York: Raven Press.Google Scholar
  61. Price, D. D. (1988). Psychological and neural mechanisms of pain. New York: Raven Press.Google Scholar
  62. Rodgers, B. M., Webb, C. J., Stergios, D., & Newman, B. M. (1988). Patient-controlled analgesia in pediatric surgery. Journal of Pediatric Surgery, 23, 259–262.PubMedCrossRefGoogle Scholar
  63. Ross, D. M. (1984). Thought-stopping: A coping strategy for impending feared events. Issues in Comprehensive Pediatric Nursing, 7, 83–89.PubMedCrossRefGoogle Scholar
  64. Ross, D. M., & Ross, S. A. (1988). Childhood pain: Current issues, research, and management. Baltimore: Urban and Schwarzenberg.Google Scholar
  65. Schechter, N. L. (Ed.). (1989). Acute pain in children. Pediatric Clinics of North America, 36, 781–1052.PubMedGoogle Scholar
  66. Schechter, N. L., Allen, D. A., & Hanson, K. (1986). Status of pediatric pain control: A comparison of hospital analgesic usage in children and adults. Pediatrics, 77, 11–15.PubMedGoogle Scholar
  67. Shannon, M., & Berde, C. B. (1989). Pharmacologic management of pain in children and adolescents. Pediatric Clinics of North America, 36, 855–872.PubMedGoogle Scholar
  68. Shapiro, L. A., Jedeikin, R. J., Shalev, D., & Hoffman, S. (1984). Epidural morphine analgesia in children. Anesthesiology, 61, 210–212.PubMedCrossRefGoogle Scholar
  69. Swafford, L. I., & Allan, D. (1968). Pain relief in the pediatric patient. Medical Clin ics of North America, 52, 131–136.Google Scholar
  70. Turk, D. C., Meichenbaum, D., & Berman, W. H. (1979). Application of biofeedback for the regulation of pain: A critical review. Psychological Bulletin, 86, 1322–1338.PubMedCrossRefGoogle Scholar
  71. Turner, J. A., & Chapman, C. R. (1982). Psychological interventions for chronic pain: A critical review. Pain, 12, 1–46.PubMedCrossRefGoogle Scholar
  72. Twycross, R. G. (1978). Pain and analgesics. Current Medical Research and Opinion, 5, 497–505.PubMedCrossRefGoogle Scholar
  73. Twycross, R. G. (1979). The Brompton cocktail. In J. Bonica & V. Ventafridda (Eds.), Advances in pain research and therapy (Vol. 2, pp. 291–300). New York: Raven Press.Google Scholar
  74. Tyler, D. C. (1987). Patient controlled analgesia in adolescents. Pain, (Suppl. 4), S236.Google Scholar
  75. Tyler, D. C., & Krane, E. J. (1990). Advances in pain research and therapy (Vol. 15). New York: Raven Press.Google Scholar
  76. Varni, J. W. (1981). Behavioral medicine in hemophilia arthritic pain management: Two case studies. Archives of Physical Medicine and Rehabilitation, 62, 183–192.PubMedGoogle Scholar
  77. Varni, J. W., Gilbert, A., & Dietrich, S. L. (1981). Behavioral medicine in pain and analgesia management for the hemophilic child with Factor VIII inhibitor. Pain, 11, 121–126.PubMedCrossRefGoogle Scholar
  78. Wakeman, R. J., & Kaplan, J. Z. (1978). An experimental study of hypnosis in painful burns. American Journal of Clinical Hypnosis, 21, 3–12.PubMedCrossRefGoogle Scholar
  79. Wolpe, J. (1982). The practice of behavior therapy. Elmsford, NY: Pergamon Press.Google Scholar
  80. Yaffe, S. J. (Ed.). (1980). Pediatric pharmacology: Therapeutic principles in practice. New York: Grune and Stratton.Google Scholar
  81. Yaksh, T. L. (1981). Spinal opiate analgesia: Characteristics and principles of action. Pain, 11, 293–346.PubMedCrossRefGoogle Scholar
  82. Zeltzer, L. K., Dash, J., & Holland, J. P. (1979). Hypnotically induced pain control in sickle cell anemia. Pediatrics, 64, 533–536.PubMedGoogle Scholar
  83. Zeltzer, L. K., & LeBaron, S. (1982). Hypnosis and nonhypnotic techniques for reduction of pain and anxiety during painful procedures in children and adolescents with cancer. Journal of Pediatrics, 101, 1032–1035.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1991

Authors and Affiliations

  • Patricia A. McGrath

There are no affiliations available

Personalised recommendations