Pain Management




General Principles



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  • Sensory nerve terminals exist on all body surfaces by 22–29 wk of gestation.





  • Pain assessment should be performed using validated tools in all patients upon admission and then at regularly defined intervals.
  • Physiologic responses to pain include increased circulating levels of catecholamines, increased HR, and increased BP.





  • Repeated or long-term painful stimuli result in long-term changes such as a lowered pain threshold.





  • Response to painful stimuli contribute to physiologic disturbances such as hypoxia, hypercarbia, acidosis, and hyperglycemia; this may lead to alterations in oxygen delivery and cerebral blood flow.





  • Infants have long-term disturbances in pain perception that persist well into childhood.





  • An absence of behavioral or physiologic cues that might indicate pain does not indicate an absence of pain.




Nonpharmacologic Management



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Behavioral Measures




  • Swaddling: Keeping the extremities flexed and close to the trunk




  • Pacifiers: Used for non-nutritive sucking




  • “Kangaroo care”

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Jan 9, 2019 | Posted by in PEDIATRICS | Comments Off on Pain Management
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