![]() However, interestingly, at the same stage A-Beta fibres show extended connections within the spinal cord that can produce nociceptive signalling from lower intensity stimuli. In the peripheral nervous system, C-fibres are mature in neonates although their cortical connections at the level of the dorsal horn are immature. As a result, a noxious stimulus may provoke different patterns of activity dependent on the stage of maturity of the paediatric central nervous system. However, many molecules, neurotransmitters and receptor-mediated systems are variably expressed depending upon developmental age. DEVELOPMENT OF PAIN PATHWAYSĪll neural pathways required for nociception are present from birth and are also functional in premature neonates. Firstly, some of the developmental neurobiological issues will be considered. However, achieving this can be difficult for a variety of reasons not least of which is the enormous variations that occur physiologically and psychologically throughout the range of ages encountered in the paediatric population. Good quality, effective management of pain in paediatric patients is therefore an essential component of paediatric anaesthesia. It is therefore essential that health care professionals looking after children of all ages are trained to recognise and treat pain whether it be acute or chronic. If pain is not adequately managed acutely there is good evidence suggesting that untreated pain may have long-term negative effects on pain sensitivity, immune functioning, neurophysiology, attitudes, and health care behaviour 1. The impact and perception of pain is also influenced by a patients’ individual developmental, environmental, and sociocultural background. This is because pain is not only a sensory perception but has emotional, cognitive, and behavioural components, which also need to be recognised. Pain can have a direct impact on health outcomes and, if uncontrolled, may have a diverse effect on all areas of life. Pain is a common reason for paediatric patients to present to hospital. The efficacy of codeine is highly variable. PCA can be used on children as young as 5 years.ĭ. Paracetamol acts by involve the inhibition of prostaglandin H2 and cyclo-oxygenase 3ī. Which of the following statements regarding paediatric analgesic pharmacology are true?Ī.Self-report is the best assessment tool in paediatrics. Neural pathways are fully developed in neonatesĬ. Paediatric pain is normally well assessed.ī. Which of the following statements regarding paediatric pain are true?Ī. ![]() The answers can be found at the end of the article, together with an explanation. Before continuing, try to answer the following questions.
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