Perioperative analgesic pharmacology in children: Difference between revisions

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Perioperative analgesic pharmacology in children (view source)

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[[File:Wfsahq-logo.png|200px|thumb|right]]
This page is under construction, converting the originally formatted pdf from the WFSA site with wiki embellishments.


''Originally from Update in Anaesthesia | www.wfsahq.org/resources/update-in-anaesthesia''
''Originally from Update in Anaesthesia | www.wfsahq.org/resources/update-in-anaesthesia''
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Glynn Williams Consultant Anaesthetist Great Ormond Street Hospital for Children NHS Trust UK. Correspondence email: willig3@gosh.nhs.uk
Glynn Williams Consultant Anaesthetist Great Ormond Street Hospital for Children NHS Trust UK. Correspondence email: willig3@gosh.nhs.uk


== INTRODUCTION ==
The inadequate treatment of pain in children following surgery was first highlighted over 20 years ago. A survey at the time found that 40% of paediatric surgical patients experienced moderate or severe postoperative pain and that 75% had insufficient analgesia. Since then increased interest in this area has led to a better understanding of the developmental neurobiology of pain and analgesic pharmacology and, consequently, allowed for the development of safer and more effective analgesic techniques for children of all ages.
== PAIN PERCEPTION ==
During foetal, neonatal and infant life the nervous system is continually evolving. This allows structural and functional changes to occur continuously in response to the child`s needs as it grows and develops. The pain pathways mirror these changes with different components developing along differing time frames. For instance the structural components required to perceive pain are present from early foetal life whereas pathways involved in modifying pain perception are still developing during infancy. Also opioid and other receptors vary in their number, type and distribution between early life and adulthood.
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|It is both desirable and possible to achieve safe, effective analgesia for children of all ages using individualised pain management planning and combined multimodal analgesic techniques
|It is both desirable and possible to achieve safe, effective analgesia for children of all ages using individualised pain management planning and combined multimodal analgesic techniques
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== INTRODUCTION ==
The inadequate treatment of pain in children following surgery was first highlighted over 20 years ago. A survey at the time found that 40% of paediatric surgical patients experienced moderate or severe postoperative pain and that 75% had insufficient analgesia. Since then increased interest in this area has led to a better understanding of the developmental neurobiology of pain and analgesic pharmacology and, consequently, allowed for the development of safer and more effective analgesic techniques for children of all ages.
== PAIN PERCEPTION ==
During foetal, neonatal and infant life the nervous system is continually evolving. This allows structural and functional changes to occur continuously in response to the child`s needs as it grows and develops. The pain pathways mirror these changes with different components developing along differing time frames. For instance the structural components required to perceive pain are present from early foetal life whereas pathways involved in modifying pain perception are still developing during infancy. Also opioid and other receptors vary in their number, type and distribution between early life and adulthood.




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