title: Pain in children who have life-limiting conditions.
abstract: Children and adolescents who have life-limiting conditions are vulnerableto acute and chronic pain problems. Many compounding and complicatingfactors often need to be explored in this setting. Barriers to effective painmanagement include poor assessment and measurement of pain anda lack of specialist knowledge. Fears regarding the use of opioids and theirassociation with the end of life must be addressed openly and with clarity.Day-to-day management should include continual appraisal of pain issuesif quality of life is to be maximized. Pain is a complicated phenomenon. The impact of pain and the compli-cated dynamic of suffering in children and young people who have life-lim-iting conditions must not be underestimated. The clinician must be vigilantand take responsibility for all aspects of pain management in these patients.
authors.affiliation: The Children's Hospital at Westmead, Corner Hawksbury Road and Hainsworth Road, Locked Bag 4001, Westmead, New South Wales 2145, Australia. reneem4@chw.edu.au
authors.forename: Renée
authors.initials: R
authors.lastname: McCulloch
authors.forename: John J
authors.initials: JJ
authors.lastname: Collins
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001921:Brain / Q000503:physiopathology; D002648:Child; D003072:Cognition Disorders / Q000453:epidemiology / Q000503:physiopathology; D016638:Critical Illness; D006801:Humans; D009294:Narcotics / Q000627:therapeutic use; D009369:Neoplasms / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology / Q000503:physiopathology* / Q000517:prevention & control*; D010147:Pain Measurement
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D009294:Narcotics