Acute pain management in children

From the Journal of Pain Research:

Abstract: The greatest advance in pediatric pain medicine is the recognition that untreated pain is a significant cause of morbidity and even mortality after surgical trauma. Accurate assessment of pain in different age groups and the effective treatment of postoperative pain is constantly being refined; with newer drugs being used alone or in combination with other drugs continues to be explored. Several advances in developmental neurobiology and pharmacology, knowledge of new analgesics and newer applications of old analgesics in the last two decades have helped the pediatric anesthesiologist in managing pain in children more efficiently. The latter include administering opioids via the skin and nasal mucosa and their addition into the neuraxial local anesthetics. Systemic opioids, nonsteroidal anti-inflammatory agents and regional analgesics alone or combined with additives are currently used to provide effective postoperative analgesia. These modalities are best utilized when combined as a multimodal approach to treat acute pain in the perioperative setting. The development of receptor specific drugs that can produce pain relief without the untoward side effects of respiratory depression will hasten the recovery and discharge of children after surgery. This review focuses on the overview of acute pain management in children, with an emphasis on pharmacological and regional anesthesia in achieving this goal.

Lack of dental care leads to high numbers of ER dental cases

From KY3:

One of the most common reasons people visit the emergency room here in Springfield is probably not what you’d think. It’s dental pain. It’s one of the biggest apparent issues discussed in a report by The Health Commission in Springfield and Greene County.

With no dental coverage and no way to afford a dentist appointment, many patients end up in pain and at the ER. In St. John’s ER, it’s the type of case that comes up many times each day; A patient with a terrible tooth ache. “We’re providing a temporizing treatment, whether it’s control the pain or if it’s an infection, to help suppress and infection,” says Dr. Ted McMurray, Medical Director of St. John’s Emergency Trauma Center.

But the ER can’t treat the root of the problem. Still, for patients 20 to 39 years old, dental cases make up more than seven percent of all ER visits in Greene County. They make up 10 percent of all Medicaid visits, and a whopping 37 percent of all uninsured visits.