From The New England Journal of Medicine
This book contains a wealth of information to assist physicians with the care of children who are in pain. The book has three sections, covering theoretical perspectives, treatment strategies, and particular problems. The first section deals with the basic science of pain, emphasizing developmental aspects and the psychological responses that influence the expression and measurement of pain during infancy and childhood. Part II describes the pharmacologic, physical, and psychological approaches that may be appropriate for different types of pain. The last section addresses a wide range of common and specific problems, such as musculoskeletal pain and pain in sickle cell disease. The flavor of the book is multidisciplinary. The editors and most of the authors are physicians, but psychologists, nurses, physical therapists, and scientists contribute many chapters; several chapters are written jointly by authors from various disciplines. An important strength of this book is the balance it maintains throughout, which enables discussions of neurosurgical procedures and anesthetic techniques for chronic pain to sit comfortably alongside chapters about nursing and physical therapy for children with pain. The importance of the psychological management of pain is reinforced throughout the book: "Health professionals cannot choose to avoid using psychology to treat pain. Our choice is whether to use psychology in a conscious, constructive fashion or to leave the psychological aspect of our interventions to chance." Some chapters from the first edition have been absorbed into other chapters in this new edition. The management of postoperative pain is addressed in chapters on opioids and peripheral-nerve blockade, as well as in many others. A new chapter deals with the problems posed by the assessment and treatment of pain in children with developmental disabilities. Another new chapter discusses complementary and alternative medical therapies for the treatment of pain in children. This sympathetic and structured chapter, supported by an appendix of resources, deserves to be read widely. Pain management for the critically ill child in the pediatric intensive care unit is reviewed in a chapter that includes a discussion of sedative agents and emphasizes the association of pain with anxiety and emotional distress. Yet another chapter covers sedation and analgesia in the emergency department. The editors have, on the whole, maintained consistency of authorship with the first edition, and North American authors predominate. However, in the second edition, in addition to factual updating, there has been a considerable and consistent change in grammar throughout. I found the book easy and enjoyable to read. Although, at 892 pages, it will not fit in your pocket, the book remains a compact single volume that can be carried easily. Whether the reader is interested in breadth (cultural considerations regarding children's pain, for example) or detail (such as information about weaning a child from intravenous fentanyl to oral methadone), the book is equally helpful. Pain in Infants, Children, and Adolescents is a comprehensive account that achieves its editors' goal, stated in the preface, "to document the remarkable changes in attitude and practice that have occurred in the area of pain and its control in children." I anticipate that the book will be widely read.
John M. Goddard, M.B., B.S.Copyright © 2003 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
Review
"This is a superb text....All professionals who deal with pain in pediatric patients will want to include this text in their library. This text will be the standard against which future texts on this topic will be measured."
