Summary

Children of all ages deserve compassionate and effective pain treatment. Analgesics should be used in effective doses, but pain and symptom management and supportive care should not be limited to medical therapies alone. Healthcare practitioners should recognize that pain treatment and prevention is essential even when children are too young or cognitively unable to report the extent and severity of their pain. Fear, anxiety and even phobias can develop as a result of painful experiences long before children can express them. Concerted efforts should be undertaken to reduce or eliminate pain whenever possible for routine medical procedures in children. This includes the use of topical local anesthetics for immunizations and phlebotomy, as well as penile nerve block or EMLA prior to circumcision. Appropriate pain management services should be available for children with chronic or recurrent pain associated with medical disease or injury. This includes all of the current modalities for treating pain in adults, as well as sedation or anesthesia for invasive procedures. Because of their lower pain thresholds and poor central modulation, infants and young children often require sedation or general anesthesia in order to undergo procedures that may be performed with minimal or no analgesia in adults.