Help in controlling pain in children: pediatrician’s tips

Abstract

The problem of anesthesia includes mainly the treatment of pre-existing pain or surgical manipulations with the use of anesthesia. However, the problems of pain prevention during traumatic (invasive) procedures are also actively solved, methods of prevention are improved and expanded, taking into account the impact of pain on the quality of life. Pain is not a simple physiological process of conducting stimulation from the receptor apparatus to the CNS structures, but a complex phenomenon that includes biological, emotional, psychological and social components. Pain is one of the earliest formed psychophysical functions; by the 30 th week of fetal development all pathways of pain conduction and perception are already formed, so both fetus and child are already capable of perceiving pain, and the intensity is often even higher than in adults. Many believe that: young children do not feel pain because their central nervous system is immature; children remember themselves from the age of 4–5 years, so they do not remember the pain they suffered, so all surgical problems that cause pain should be addressed as early as possible; if the child is sleeping or playing, he or she has no pain, etc. Current research has demonstrated significant short-term adverse reactions and long-term negative effects in children in response to pain-related manipulations. Anesthesia of intact skin was previously impossible without prior painful anesthetic injection. Today, other ways of administering anesthetics are used as alternatives: oral, in enemas or suppositories, locally as sprays, ointments, or by application. To address the pain associated with invasive procedures, the effectiveness of a 5% local anesthetic cream based on a water-oil emulsion of lidocaine and prilocaine (1:1), which has good absorption properties, has been studied. Using local anesthesia can prevent and/or reduce the risk of pain-induced stress. Considering the results of these studies, the use of a local combined anesthetic containing 2.5% lidocaine and 2.5% prilocaine may be suggested.