Published online November 1, 2004
PEDIATRICS Vol. 114 No. 5 November 2004, pp. 1335-1337 (doi:10.1542/peds.2004-0621)
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COMMENTARY

Preemptive Strike in the War on Pain: Is It a Safe Strategy for Our Vulnerable Infants?

Hany Aly, MD

Department of Neonatology, George Washington University and Children's National Medical Center, Washington, DC 20037

Abbreviations: NICU, neonatal intensive care unit

The first 20% of the full text of this article appears below.

Among the remedies which it has pleased Almighty God to give to man to relieve his sufferings, none is so universal and so efficacious as opium.

Dr Thomas Sydenham (1624–1689)

What a great medicine to relieve pain and emotional stress. With no side effects known at that time, opium was perceived as almost miraculous and became very popular for relieving the suffering of patients with a wide variety of diseases, such as insomnia, headaches, and epilepsy (among many others). Overworked parents also used opium as a pacifying remedy for their harassed infants. Morphine was later extracted from opium and named after Morpheus, the Greek god of dreams.2

The perception of opium changed to the opposite extreme after recognition of its addictive nature. In his remarks about the suffering of the world from opium destruction, Dr John Witherspoon, president of the American Medical Association early in the 20th century, urged the medical community to "save our people from the clutches of this hydra-headed monster which stalks abroad throughout the civilized world, wrecking lives and happy homes, filling our jails and lunatic asylums, and taking from these unfortunates the precious promise of eternal life."3

The ancient Egyptian pharaohs discovered opiates almost 5000 years ago, but their physicians were versed in its medical use. They opted to use other remedies, such as salicyl compounds for relief of rheumatic pain and local cryoanalgesia for male circumcision, a surgical procedure that was routinely performed for young men just before marriage.4

Pain can complicate the illnesses of infants in general and premature infants in particular. Repetitive noxious stimuli . . . [Full Text of this Article]

Address correspondence to Hany Aly, MD, 900 23rd St NW, Suite G-2092, Washington, DC 20037. E-mail: haly@mfa.gwu.edu




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