Plenární přednáška

PEDIATRIC PAIN: GUIDELINES; EVIDENCE AND RELIGION

Tibboel D.

Intensive Care and department of pediatric surgery; Erasmus MC Sophia Children’s Hospital; Rotterdam, The Netherlands

Pain as a symptom has moved from its original definition related to actual tissue damage towards the concept of a biopsychosocial phenomenon. As a consequence self-report has become the Gold standard for pain evaluation in children over 3 years of age. Both non-pharmacological measures and drug therapy is reported under these circumstances in relation to changes in the level of pain.

In contrast, for children less than 3 years of age, pain assessment by nurses and medical professionals has gained attention with inherent short comings in daily clinical practice. These are related to the variety in assessment instruments, which are still mainly used in research settings, together with differences in the pharmacokinetics of analgesic drugs in the youngest age groups.

In many countries nowadays national guidelines are available initiated by the societies of anaesthesiology and/or pediatrics for children of different age groups and conditions (procedural; postoperative etc.).

Importantly scoring in the absence of a treatment algorithm is useless while compliance in daily clinical practice still remains a challenge in many clinics.

As long as the level of evidence of (inter)national guidelines is not always optimal “space” for local or personal religion based analgesic therapy is still available.