Early life pain—effects in the adult

Walker, Suellen M.

doi:10.1016/j.cophys.2019.04.011

Cited by 28 publications

(15 citation statements)

References 72 publications

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“…Similarly, following administration of the chemotherapeutic agents vincristine [69] or cisplatin [70] in juvenile rodents, persistent hypersensitivity emerges only at older ages. Surgical incision in neonatal rodents alters long-term sensitivity of spinal circuits, spinal neuroimmune signalling, and activity in ascending and descending pathways, that contributes to altered baseline thresholds and an enhanced response to surgical injury in later life [71] . Therefore, both pre-clinical and clinical data identify age-dependent changes in mechanisms and/or presentation that support the potential for, and need to recognise, delayed onset neuropathic pain following traumatic nerve injury, cancer treatment, and surgery in children.…”

Section: Causes With Specific Paediatric or Emerging Implicationsmentioning

confidence: 99%

Neuropathic pain in children: Steps towards improved recognition and management

Walker

2020

eBioMedicine

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Neuropathic pain in children can be severe and persistent, difficult to recognise and manage, and associated with significant pain-related disability. Recognition based on clinical history and sensory descriptors is challenging in young children, and screening tools require further validation at older ages. Confirmatory tests can identify the disease or lesion of the somatosensory nervous system resulting in neuropathic pain, but feasibility and interpretation may be influenced by age-and sex-dependent changes throughout development. Quantitative sensory testing identifies specific mechanism-related sensory profiles; brain imaging is a potential biomarker of alterations in central processing and modulation of both sensory and affective components of pain; and genetic analysis can reveal known and new causes of neuropathic pain. Alongside existing patient-and parent-reported outcome measures, somatosensory system research methodologies and validation of mechanism-based standardised end-points may inform individualised therapy and stratification for clinical trials that will improve evidence-based management of neuropathic pain in children.

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Section: Causes With Specific Paediatric or Emerging Implicationsmentioning

confidence: 99%

Neuropathic pain in children: Steps towards improved recognition and management

Walker

2020

eBioMedicine

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“…Similarly, data from a tertiary pediatric hospital document low overall perioperative mortality in children and adolescents, but higher rates in neonates . Additional levels of physiological instability or potential long‐term effects on neurodevelopmental outcome or pain response may also result in core outcome sets for neonates and infants differing from older children.…”

Section: The Need For Core Outcome Sets For Pediatric Perioperative Carementioning

confidence: 99%

Pediatric perioperative outcomes: Protocol for a systematic literature review and identification of a core outcome set for infants, children, and young people requiring anesthesia and surgery

Razavi

Walker²,

Moonesinghe

et al. 2020

Pediatric Anesthesia

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Clinical outcomes are measurable changes in health, function, or quality of life that are important for evaluating the quality of care and comparing the efficacy of interventions. However, clinical outcomes and related measurement tools need to be well-defined, relevant, and valid. In adults, Core Outcome Measures in Effectiveness Trials (COMET) methodology has been used to develop core outcome sets for perioperative care. Systematic literature reviews identified standardized endpoints (StEP) and valid measurement tools, and consensus across a broader range of relevant stakeholders was achieved via a Delphi process to establish Core Outcome Measures

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“…Additionally, newborn infants with a high risk of neurological impairment are subjected to a greater number of painful procedures during their first days of life than newborn infants with lower risk, and despite this, the high-risk infants usually receive less analgesics such as opioids [ 9 ]. Painful experiences in newborns can result in altered pain responses later in life [ 10 ] and can also impair the infants’ brain development [ 11 ]. Assessing pain in infants that are not only post-asphyxiated but also treated with TH is a difficult task due to their neurological deficiencies.…”

Section: Introductionmentioning

confidence: 99%

“…Pain needs to be adequately managed in all patients, including the newborn infant. Painful procedures and inadequate pain management lead to both short- and long-term negative effects [ 10 ]. Despite the pain and stress associated with TH, pain management and sedation of the infant during TH have not been systematically assessed for what is the best practice and clinical practices vary widely [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Interventions for the management of Pain and Sedation in Newborns undergoing Therapeutic hypothermia for hypoxic-ischemic encephalopathy (IPSNUT): protocol of a systematic review

et al. 2022

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Background Clinical research has shown that therapeutic hypothermia after neonatal hypoxic-ischemic injury improves survival without disability. There is no consensus regarding pain relief or sedation during therapeutic hypothermia in newborns; however, therapeutic hypothermia seems to be associated with pain and stress, and adequate analgesia and sedation are central to maximize the effect of therapeutic hypothermia. Pain needs to be adequately managed in all patients, especially the newborn infant due to the potential short- and long-term negative effects of inadequately treated pain in this population. Methods We will perform a systematic review of pharmacological and non-pharmacological interventions for the management of pain and sedation in newborn infants undergoing therapeutic hypothermia for hypoxic-ischemic encephalopathy. We will include randomized, quasi-randomized controlled trials and observational studies. The use of pharmacological or non-pharmacological interventions will be compared to other pharmacological and or non-pharmacological interventions or no intervention/placebo. The primary outcomes for this review will be analgesia and sedation assessed with validated pain scales, circulatory instability, mortality to discharge, and moderate-to-severe neurodevelopmental disability. We will search the following databases: CINAHL, ClinicalTrials.gov, Cochrane Library, Embase, PubMed, Scopus, and Web of Science. Two independent researchers will screen the records for inclusion, extract data using a data extraction form, and assess the risk of bias in the included trials. Discussion The result of this review will summarize the knowledge regarding the management of pain and sedation in infants treated with therapeutic hypothermia and potentially provide clinicians with guidance on the effective and safe methods. Systematic review registration PROSPERO CRD42020205755

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Early life pain—effects in the adult

Cited by 28 publications

References 72 publications

Neuropathic pain in children: Steps towards improved recognition and management

Neuropathic pain in children: Steps towards improved recognition and management

Pediatric perioperative outcomes: Protocol for a systematic literature review and identification of a core outcome set for infants, children, and young people requiring anesthesia and surgery

Interventions for the management of Pain and Sedation in Newborns undergoing Therapeutic hypothermia for hypoxic-ischemic encephalopathy (IPSNUT): protocol of a systematic review

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