Current trends in pediatric pain management: from preoperative to the postoperative bedside and beyond

Pediatric pain management for children undergoing surgical care presents unique and significant challenges for clinicians. Effective and thoughtful pain management begins prior to the child’s arrival in the facility’s preanesthesia holding room, lasts throughout the entire perioperative process, and well into the postoperative period. The nature of pain, particularly in children, is complex and results from the interplay of biological, psychological, social, and spiritual factors influencing not only the child, but also the child’s family. We now know that adequate pediatric pain management may improve both short- and long-term health outcomes for many years following surgical intervention. This manuscript reviews the current state-of-the-art trends in neonatal and pediatric pain assessment and management. Topics included in this review are pain assessment, neonatal pain, opioids, regional anesthesia, and psychological and physical strategies for reducing acute pediatric pain.