PubMed · 10497570
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S Fisher. Small relief.. https://pubmed.ncbi.nlm.nih.gov/10497570/
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Postoperative analgesia is not adequate in France. An improvement is necessary for both the patient's comfort and the possible reduction of postoperative morbidity. The cornerstone of postoperative analgesia is regular evaluation of pain allowing adapted treatment. The organisation of postoperative analgesia requires teaching of medical and paramedical staff, the agreement on protocols with designation of a pain referent according to a quality insurance program. Available treatments include non-opioid and opioid drugs and local anaesthetic agents. Main difficulties include interindividual variability, and analgesia on movement. Patient-controlled analgesia allows adaptation of opioid treatment to patient's needs. The combination of drugs and techniques may allow a better analgesia, and a reduction of its side effects.
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Children frequently received no treatment, or inadequate treatment, for pain and for painful procedures. The newborn and critically ill children are especially vulnerable to no treatment or under-treatment. Nerve pathways essential for the transmission and perception of pain are present and functioning by 24 weeks of gestation. The failure to provide analgesia for pain results in rewiring the nerve pathways responsible for pain transmission in the dorsal horn of the spinal cord and results in increased pain perception for future painful results. Many children would withdraw or deny their pain in an attempt to avoid yet another terrifying and painful experiences, such as the intramuscular injections. Societal fears of opioid addiction and lack of advocacy are also causal factors in the under-treatment of pediatric pain. False beliefs about addictions and proper use of acetaminophen and other analgesics resulted in the failure to provide analgesia to children. All children even the newborn and critically ill require analgesia for pain and painful procedures. Unbelieved pain interferes with sleep, leads to fatigue and a sense of helplessness, and may result in increased morbidity or mortality.