Pediatric Office Pain: Crying for Attention

October 2011 marked the close of the Global Year Against Acute Pain.¹ This campaign, initiated by the International Association for the Study of Pain, was developed to promote uniformity in the treatment of pain associated with surgery, trauma, and childbirth. The effort likely escaped the notice of most pediatricians whose days and nights are typically spent providing care to children in less dramatic situations. The important implications of this initiative for office-based practitioners are nevertheless worth reviewing.

A mere few decades ago, neonatal surgery was often performed without anesthesia,² postoperative pain management was typically an afterthought,^3–5 and many significant procedures were conducted without local anesthesia or sedation. The recognition that pain exists in children, as well as its measurement and treatment, are products of research undertaken toward the end of the 20th century. Numerous textbooks,^6–8 the American Academy of Pediatrics,⁹ and a litany of other professional societies^10–12 have summarized this new information and developed evidence-based guidelines to reduce pain, especially …

Address correspondence to F. Ralph Berberich, MD, Pediatric Suggestions, 2019 Los Angeles Ave, Berkeley, CA 94707. E-mail: dr.berberich{at}pediatricsuggestions.net