title: [Postoperative pain assessment in special patient groups: part II. Children with cognitive impairment].
abstract: Postoperative pain assessment in children with cognitive impairment poses major challenges to healthcare professionals.Children with moderate to severe cognitive impairment are generally unable to communicate effectively and to self-report the level of pain. Difficulties assessing pain have led to their exclusion from clinical trials and rendered them vulnerable to insufficient treatment of pain.The realization of pain is a particularly important step forward for a better care of children with cognitive impairment.Scales based on a child's own perception of pain and its severity play a limited role in this vulnerable population and pain assessment tools which rely on observing pain behavior are essential. The r-FLACC, which is reliable and valid, includes specific behavioral descriptors and can be used simply and effectively postoperatively in clinical practice. Our task has to be assessing pain as a routine procedure in cognitively impaired children as a keystone for an improved and successful pain management in this very sensitive patient population.
authors.affiliation: Univ Klinik für Anästhesiologie und Intensivmedizin, Medizinische Universität Graz, Auenbruggerplatz 29, 8036 Graz, Austria.
authors.forename: B
authors.initials: B
authors.lastname: Messerer
authors.forename: J
authors.initials: J
authors.lastname: Meschik
authors.forename: A
authors.initials: A
authors.lastname: Gutmann
authors.forename: M
authors.initials: M
authors.lastname: Vittinghoff
authors.forename: A
authors.initials: A
authors.lastname: Sandner-Kiesling
mesh_terms: D002648:Child; D002671:Child, Exceptional / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000523:psychology*; D007363:Intensive Care Units, Neonatal; D008297:Male; D009633:Nonverbal Communication; D010147:Pain Measurement / Q000379:methods*; D010149:Postoperative Pain / Q000145:classification / Q000175:diagnosis* / Q000628:therapy; D010817:Physician-Patient Relations; D011785:Quality Assurance, Health Care / Q000379:methods*; D015203:Reproducibility of Results; D014705:Verbal Behavior