Table 1.

General principles of procedural pain management (^*9)

1. Infants and children of all ages, including preterm neonates feel pain and require analgesia for painful procedures.

2. Developmental differences in responses to pain and analgesics need to be considered when choosing analgesia.

3. Consider if the planned procedure is necessary: Avoid multiple procedures where possible Consider how the information gained may influence care Consider whether modification of procedure may reduce pain e.g. venepuncture less painful than heel lance.

4. Consider whether sedation or general anaesthesia may be required for safe and satisfactory outcome.

5. Ensure suitable environment: a quiet, calm location with suitable toys and distractions.

6. Ensure appropriate personnel are available: enlist additional experienced help when necessary.

7. Allow sufficient time for analgesic measures and medications to be effective.

8. Formulate a clear plan of action should the procedure fail or pain become unmanageable using the techniques selected.

GOOD PRACTICE POINT: Pain management for procedural pain should be planned, taking into account general principles and should include both pharmacological and non-pharmacological strategies wherever possible.

^*From: Association of Paediatric Anaesthetists of Great Britain and Ireland. Good practice in postoperative and procedural pain London, APA 2008 Available from http://www.apagbi.org.uk/sites/apagbi.org.uk/files/APA%20Guideline%20part%201.pdf