Sedation and analgesia in children with cerebral palsy: a narrative review

Ingrid Rabach, Francesca Peri, Marta Minute, Emanuela Aru, Marianna Lucafò, Alberto Di Mascio, Giorgio Cozzi, Egidio Barbi

Research output: Contribution to journalReview article

Abstract

Background: Patients with cognitive impairment due to cerebral palsy experience pain more often than healthy peers and frequently require diagnostic and therapeutic painful procedures. Analgesia and procedural sedation outside the operating room are often required, but they may not adequately be provided because of the inability to accurately recognize and classify the state of pain and for the perceived higher risk of complications. Data sources: We reviewed the available literature to highlight the specific risk factors and area of criticism, that should be further improved. We searched the Cochrane Library, Medline, Pubmed from 1987 to September 2018 using key words such as ‘cerebral palsy and children and pain’ or ‘sedation and cerebral palsy and children’. Results: While different pain scales are useful in recognizing pain expressions, anxiety scales are not available. Moreover, studies on non-pharmacological techniques do not always have comparable results. Several risk factors, from anatomic abnormalities to liver and kidney functioning, should be kept in mind before proceeding with sedation. Conclusions: Large trials are needed to assess the impact of non-pharmacological techniques and to evaluate which pain control strategy (pharmacological and non-pharmacological) should be used in different settings.

Original languageEnglish
Pages (from-to)432-440
Number of pages9
JournalWorld Journal of Pediatrics
Volume15
Issue number5
DOIs
Publication statusPublished - Oct 1 2019

Keywords

  • Analgesia
  • Cerebral palsy
  • Intellectual disability
  • Pain
  • Procedural sedation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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