Physicochemical Basis of Pain Intervention

Pain management can be approached by intervening at various points of the nociceptive pathway. Transduction is the conversion of the peripheral stimulus at the nociceptor into an electrical signal (35). Agents that have been shown to work at the periphery include nonsteroidal anti-inflammatory agents and capsaicin. Transmission is the afferent ascendance of the electrical signal from the periphery to the neuraxis. Local anesthetics temporarily block transmission. Modulation (i.e., inhibition or...

Principles of Pediatric Pain Management

Tenets of good pain management for children are as follows First, give medications by the clock. Around-the-clock administration ensures consistent plasma levels. As-needed (prn, pro re nata) administration has been interpreted by staff to mean as little as possible. Suboptimal dosing by 25 as-needed scheduling has been documented in adults (44). Second, give by the oral route when possible. Novel routes to consider are sublingual, rectal, intranasal, inhalational, and subcutaneous...

Diet and Eating Habits at School

For children with recurrent abdominal pain, Walker noted that diet and eating habits may exacerbate symptoms (4). Available foods and schedules for school lunch may contribute to symptoms. Many children may not have sufficient time to ingest their food and use the bathroom in the amount of time provided for lunch. In other cases, the types of food and beverages may also increase gastrointestinal symptoms and result in abdominal distress. In such cases, parents can advocate for specialized...

CAM Approaches for Pediatric Pain 21 Acupuncture

In adults, acupuncture is among the most frequently used CAM treatments for chronic medical conditions (15-17), and its effectiveness has been supported for several specific pain problems, such as headaches (18) and chronic back pain (19). Reports of serious adverse effects are rare (20,21). Although the exact mechanisms by which acupuncture exerts analgesic effects have not been specified, numerous investigations have demonstrated that the nervous system, neurotransmitters, endogenous...

Herbal Medicine

There are few published studies of herbal medicine as a pediatric therapy, despite the general popularity of herbal remedies (9) and the likelihood that many are given to children in the home. The only two existing studies that were randomized, double-blinded controlled trials were conducted by Sarrell and colleagues to evaluate a naturopathic herbal extract (NHE) for ear pain associated with acute otitis media (AOM) (55,56). Although well designed, both studies excluded children younger than 5...

Pain Associated With Common Infections

Otitis media is the most frequent illness diagnosis made in pediatric practice for children younger than 15 years old. By 1 year, 60 of children will have been diagnosed with otitis media, and by 3 years of age, 80 of children will have had at least one episode (66). In a survey by the Centers for Disease Control and Prevention in 1990, otitis media was the primary diagnosis at 24.5 million visits to the doctor (67). Paradise et al. examined the records of more than 2200 Pittsburgh area infants...

Introduction and Epidemiology

Complementary and alternative medicine (CAM) is defined as those therapeutic interventions not widely established for use in conventional health care practice or incorporated into the standard medical curriculum (1). Although reports suggested that use of CAM has increased substantially in pediatric health care (2), estimates of CAM use for the treatment of children vary from From Bringing Pain Relief to Children Treatment Approaches Edited by G. A. Finley, P. J. McGrath, and C. T. Chambers...