[Perioperative pain therapy. Deficiencies in children and adolescents].
Present studies reveal that postoperative pain management for children is still insufficient in Germany. This situation is not only caused by a lack of knowledge, but, mainly, by a deficiency of standardized protocols in the hospitals and the lack of administrative responsibility. This article describes a specific concept for postoperative pain management in children. It basically focuses on three main topics: prevention of pain, the algorithm for analgesic treatment and the evaluation of the efficiency of the treatment. The surgeon plays a central role in pain prevention. By intraoperative blocking of the peripheral nerves, he can achieve effective analgesia. Postoperatively, he prescribes a basic medication according to the procedure used and the surgical trauma. Its effectiveness must be measured routinely thereafter and, depending on the score, an individual pain medication should be added. Pain measurement in children requires the application of specific scales for each age group. The evaluation of this concept has revealed therapeutic success, broad acceptance and efficiency in ward use. However a long-term benefit can only be achieved when postoperative pain management is one of the essential duties of the surgeon and it is constantly monitored within a department.
Till
H
H
Kinderchirurgische Klinik im Dr. v. Haunerschen Kinderspital der LMU, München, Germany. holger.till@kk-i.med.uni-muenchen.de
Heinrich
M
M
Joppich
I
I
D000293:Adolescent; D000465:Algorithms; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D000772:Anesthesia, Local; D002648:Child; D002675:Child, Preschool; D005858:Germany; D006801:Humans; D007223:Infant; D020380:Needs Assessment; D010147:Pain Measurement; D010149:Postoperative Pain / Q000145:classification / Q000188:drug therapy* / Q000517:prevention & control; D011785:Quality Assurance, Health Care; D016896:Treatment Outcome
D000700:Analgesics