Treating pain in children
The health care profession has made strides in the areas of neonatal (newborn) and pediatric (relating to children) pain management. When treating children for pain, health care professionals should tailor care to the child’s level of development. Some additional factors to consider include a child’s:
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Understanding of medical procedures
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Verbal skills
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Ability to separate from parents
Pain measurement in children
The most difficult task involved with treating pain in children is obtaining an objective and accurate measurement of pain. Most of the methods available do not apply to all age groups. No single method has been accepted universally.
Methods for measuring pain in children can be divided into three categories:
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Self-reported measures of pain—These measures include routine questions, verbal scales, numeric scales, and pictorial scales.
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Behavioral measures of pain—Such measures include motor responses, facial expressions, crying, and behavioral responses (such as sleep-wake patterns).
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Physiologic measures of pain—These include blood pressure and pulse changes, in addition to measurement of palm-sweating.
Considerations when using drugs to treat pain in children
It is important to remember that children are not just small adults. For example, they metabolize drugs differently and have a higher percentage of body weight as water and less as fat than do adults. This affects the way drugs work and also how the drugs are broken down and removed from the body.
Examples of pain relievers for children include NSAIDs, acetaminophen, and opioids. The use of NSAIDs (non-steroidal anti-inflammatory drugs) in children—except for newborns —is not much different than its use in adults. NSAIDs (such as Motrin) generally are not recommended for babies who are younger than 6 months old. Acetaminophen (Tylenol), another medicine available over-the-counter, is commonly used to treat pain in children. Most opioids (such as codeine) used to treat pain in children also produce good pain relief. These are prescription-only medicines.
While these medicines are the same as those given to adults for pain, it is important to know that the dosing is not the same for children. The dose of medicine will likely be smaller for children than for the average adult because it is based on the patient’s weight. In addition, pain medicines for children can be given via different routes (such as nasally or as lollipops).
Other drugs used to treat pain in children include antidepressants and patient-controlled analgesia (PCA). Children who are 4 to 6 years old might be able to use PCA with the help of a parent or nurse. Children who are as young as 7 can independently use the PCA pump.
Other methods of pain relief in children include epidural analgesia.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.This document was last reviewed on: 1/24/2005
