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Relieving pain ht children effectively Historically pain has been undertreated in

children and infants, and this lack of treatment has allowed the persistence of unnecessary suffering in this patient group, especially chronically and critically ill children.

Adequate pain control is particularly important in the management of neonates and infants, according to Associate Professors Frederick Burrows and Charles Berde from Harvard Medical School Children's Hospital, Boston, US. Recent studies have shown that substantial humoral, metabolic and cardiovascualr responses to painful and stressful stimulation occur in paediatric patients of various ages during routine surgery and minor invasive or

diagnostic procedures [see Inpharma 902: 14. 28 Aug 1993]. Burrows and Berde feel that these responses may increase the risk of morbidity or death.

There has been opposition to the use of morphine in infants. However, morphine infusions can be used safely in infants with titrated administration and increased observation, and children as young as 5-7 years can use patient controlled analgesia effectively, the authors state. In addition, regional anaesthesia appears to be an excellent method of pain relief in infants and children after surgery. Burrows FA. Berde CB. Optimal pain relief in infants and children. Safe methods of analg~sia and anaesthesia are now available. British Medical Journal 307: 815-816.2 Oct 1993 IIIIZ2>6OO

9 Oct 1993 INPHARMAe ISSN 0156-2703l9311009-0061$1.00c Adlslntematlonal Ltd