Archive for Wednesday, September 5, 2001

Groups take doctors to task on children’s pain

September 5, 2001

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— Infants usually cry when they get circumcised. Children often wince when they get shots. Some young cancer patients dread giving blood samples.

Children feel pain as much as adults, and doctors should do more to relieve children's pain from injuries, illnesses and medical procedures, the American Academy of Pediatrics and the American Pain Society declared Tuesday in a new joint policy statement.

"Children are needlessly suffering," said Dr. Michael Ashburn, APS president and director of pain programs at the University of Utah. "Poorly treated pain following a procedure can lead to prolonged healing and make children at a higher risk for adverse side effects."

Doctors need to re-evaluate their routines to better anticipate and assess pain in children, create a soothing environment in their offices and involve parents in preventive measures, the statement said. It also recommended that pediatricians press for child-specific research in pain management and urge the Food and Drug Administration to evaluate pain relievers for children.

The statement appears in the September issue of the journal Pediatrics.

While there is extensive literature describing how to evaluate and treat acute pain in children, doctors have not done as much as they should to prevent or relieve that discomfort for several reasons, including a misconception that youngsters don't feel pain as adults do, the statement says.

Other factors cited include doctors' lack of training to evaluate pain in children, fears about side effects of pain medication, and the belief among some health care workers that pain builds character.

The two groups began working on the statement in 1995, after health-care professionals realized children's pain was undertreated and after new techniques to assess pain were developed, said Dr. Joseph Hagan, a Vermont pediatrician and chairman of the AAP committee that wrote the statement.

Pain in children with long-term illnesses can cause stress that weakens their immune systems, resulting in a slower recovery, said June Dahl, a professor at the University of Wisconsin Medical School and a pain specialist.

But when a youngster has cancer, for example, the focus often is on keeping the child alive, she said.

"The pain gets lost in the shuffle," Dahl said.

A child who needs blood drawn weekly, for example, would feel less pain if a cream were used to numb the skin and if the youngster were reassured by parents and doctor during the procedure, Ashburn said.

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