PEDIATRIC PROCEDURAL PAIN MANAGEMENT: A REVIEW OF THE LITERATURE

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 These include: outdated beliefs about pain management; inconsistent use of evidence-based interventions; difficulties assessing children's pain; and the role of the values and beliefs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.