Der Schmerz
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Practice Guideline
[Austrian interdisciplinary recommendations on pediatric perioperative pain management : Background, aims, methods and key messages].
These recommendations were originally commissioned by the"Österreichische Gesellschaft für Anästhesiologie, Reanimation und Intensivmedizin" (ÖGARI, Austrian Society for Anesthesiology, Resuscitation and Intensive Care Medicine). Against this background, Austrian experts from the disciplines anesthesiology, pain management, pediatrics and the "Berufsverband Kinderkrankenpflege" (Professional Association of Pediatric Nursing) have with legal support developed evidence-based and consensus recommendations for the clinical practice. ⋯ The complete recommendations on pediatric perioperative pain management consist of seven separate articles which each deal with special sub-topics with comments on and explanations of the key messages. The target groups of the recommendations are all medical personnel of the individual disciplines involved in the treatment of perioperative and posttraumatic pain for neonates, infants and children up to 18 years old.
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Pharmaceuticals are not always licensed for all medically indicated areas and types of application. The off label use of pharmaceuticals is particularly common in pediatrics. The obligatory licensing of pharmaceuticals according to § 7 AMG (drug registration and administration act) only applies to the dispensing and provision but not for the use in patients, particularly in a perioperative setting. ⋯ Pharmaceuticals can only be used after obtaining appropriate informed consent. The off label use of medications is allowed and sometimes necessary under these prerequisites as long as the administration of the medication is medically indicated and shows promise of success. Furthermore, an application can be permissible for"curative intent".
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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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Neuropathic pain is caused by lesions in the somatosensory system. Characteristic but not exclusive features are spontaneous burning pain, electrifying and shooting pain, hyperalgesia, and allodynia. The basic concept of the pathophysiology of neuropathic pain is the combination of peripheral and central sensitization. ⋯ In addition, there are many more therapeutic options available than 15 years ago. The drugs available include antidepressants, anticonvulsants, opioids, and topical medications. Data from controlled trials and recommendations from guidelines are available.