PEDIATRIC PROCEDURAL PAIN MANAGEMENT: A REVIEW OF THE LITERATURE

Abstract: Research in the last two decades has revealed the complex nature of pain and has thereby improved the understanding, treatment, and management of pediatric pain by health care practitioners. However, a significant gap between knowledge and practice still exists. Pediatric pain remains under-managed. Several themes emerged in this literature review as factors influencing adequate pain management. These include: outdated beliefs about pain management; inconsistent use of evidence-based interventions; difficulties assessing children’s pain; and the role of the values and beliefs of caregivers and practitioners. The literature indicates a high risk of deleterious consequences of under-managed pediatric pain, linking early health care experiences to later health-seeking behaviours. Implications for practice are considerable. Recommendations include: an individualized “3-P ” approach combining pharmacologic, physical and psychological strategies; collaborative approaches eliciting expertise from caregivers and health care professionals across multiple disciplines; and utilizing interventions before, during, and after procedures