Der Schmerz
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Practice Guideline
[Pharmacodynamic and pharmacokinetic characteristics of pain therapy in neonates : Austrian interdisciplinary recommendations on pediatric perioperative pain management].
The false assumption that neonates are less sensitive to pain than adults led to a long delay in the introduction of a reasonable pain therapy for children. Even if the basic principles of the development, transmission and perception of pain in premature infants and neonates are not completely understood, the results of studies have clearly shown that pain can be perceived from 22 weeks of gestation onwards. This knowledge results in the necessity to also administer an adequate pain therapy to premature and newly born infants. ⋯ The different physical proportions also modify the dosing of pharmaceuticals. Children in the first year of life differ substantially from adults in physiology, pharmacodynamics and pharmacokinetics. The care of neonates and infants requires specialist knowledge which is described in this article.
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Practice Guideline
[Organization of pediatric pain management : Austrian interdisciplinary recommendations for pediatric perioperative pain management].
Postoperative pain management is still in need of vast improvement, especially for children. The aim of this article is to demonstrate which structures and processes must be optimized to ultimately improve patient satisfaction and safety. ⋯ Whether improvements in acute pediatric pain therapy will actually be achieved can only be realized by standardized compilation and analysis of the quality of therapy. For this purpose QUIPSInfant was developed.
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In recent decades, the focus of pain management in hospitals was the organization and quality of control of postoperative pain, although there is a similar demand in nonsurgical departments. The aim of this study was to assess the employees' perspective on problems and corresponding solutions in pain management in a university hospital and to further clarify whether the implementation of concepts and tools of pain management across disciplines is feasible. ⋯ The results demonstrate that from the employee's perspective problems in pain management in surgical and nonsurgical departments are very similar. Transferring concepts and structures of surgical pain management, such as standardized concepts and advice and or care through pain services, would meet high levels of acceptance. The results also indicate that the nursing staff's ability to treat should be increased by the provision of adequate rescue-analgesics. To close deficits in the management of care, established concepts of pain management could be extended to all departments of a hospital. Similarities outweigh differences in the employee's assessment.