These guidelines have been developed to support countries to relieve pain in their paediatric populations. These guidelines address persisting pain in children caused by conditions such as cancer, HIV/AIDS, sickle-cell disease, burns, trauma, and phantom limb pain. Recommendations -- developed following a careful and transparent appraisal of available evidence -- are presented for the pharmacological treatment of mild, moderate and severe pain. The guidelines include chapters on the various systems used to classify pain and on the evaluation of pain, which reviews the available tools for routine pain measurement in children. Provision of sustainable pain relief within health care systems is covered in a separate chapter.
Since morphine and other opioid analgesics -- required for the relief of moderate-to-severe pain in children-- are listed under the 1961 UN Single Convention on Narcotic Drugs, the new guidelines include an annex explaining the Convention's requirements for the handling and procurement of opioid analgesics for the relief of pain.
On the contents of this package
This package consists of four publications and four tools:
o WHO guidelines on the pharmacological treatment of persisting pain in children with medical illnesses
o Three brochures with important information for:
o physicians and nurses;
o policy-makers and medicines regulatory authorities, hospital managers and health insurance managers
o Dosing card
o Pain Scale for children (4 years of age and up)
o Pain Scale for children (6 - 10 years)
o Wall chart for waiting rooms
The brochures provide important background information on the treatment of pain in children that can be helpful for ensuring adequate access to pain treatment. The dosing card provides brief information on the dosing of the substances described in the guidelines. For more detailed information and additional references we refer to the formal guidelines document. In case of any discrepancy between the brochures or the dosing card and the guidelines document, the guidelines document should be the reference.
The pain scales, as they were not part of the evidence evaluation, are not part of the guidelines, but are provided to facilitate pain assessment in children. WHO did not assess the evidence behind the pain scales in full. We refer to the guidelines for more information. The wall chart is intended to promote familiarity with pain control among the general public, and more particularly among caregivers, who should be encouraged to ask for pain management for the child.
We encourage that the brochures be shared with as many relevant colleagues as possible. However, they are not a substitute for the more detailed information contained in the guidelines document. Health-care professionals should read the guidelines document if possible.