Title Klinički pristup i liječenje boli u djece Title (english) Clinical approach and treatment of pain in children Author Sara Golub Mentor Ana Milardović (mentor)Committee member Gordana Blagojević Zagorac (predsjednik povjerenstva)Committee member Iva Bilić Čače (član povjerenstva)Committee member Goran Palčevski (član povjerenstva)Granter University of Rijeka Defense date and country 2022-07-15, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Klinički pristup i evaluacija boli u djece obuhvaćaju sljedeće: određivanje tipa i karaktera boli, izvora, lokalizacije i uz njih pratećih/povezanih znakova i simptoma te procjenu intenziteta boli. Osim navedenog, potrebno je utvrditi točan period u kojem se bol pojavila te odrediti njezino trajanje. Bol prema tipu može biti nociceptivna, neuropatska ili nociplastična, a svaki tip boli povezuje se s određenim karakterom: oštra, tupa, stiskajuća, probadajuća, grčevita, žareća, pulsirajuća i slično. Izvor i lokalizacija boli pomažu u određivanju njezine etiologije a prateći/povezani simptomi sužavaju diferencijalnu dijagnozu i ukazuju na onu najvjerojatniju. Samoprocjena intenziteta boli u djece ovisi o životnoj dobi djeteta odnosno o njegovoj kognitivnoj sposobnosti. Za procjenu se koriste: metoda samoprocjene, koja podrazumijeva dobno prilagođene ljestvice i upitnike o boli, namjenjena za djecu koja su sposobna razumjeti bol, kvantificirati ju i vizualizirati, te bihevioralno opservacijska metoda, gdje se promatraju fiziološki parametri i ponašanje djetata, namjenjena za djecu koja nisu sposobna sama procijeniti bol i nemaju sposobnost verbalizacije. Liječenje boli u djece uključuje nefarmakološke i farmakološke mjere. Nefarmakološko liječenje podrazumijeva fizikalne, bihevioralne i kognitivne metode. Farmakološko liječenje najčešće se provodi prema trostupanjskoj analgetičkoj ljestvici Svjetske zdravstvene organizacije, i obuhvaća sljedeće skupine lijekova: neopioidni analgetici (paracetamol i NSAID), opioidni analgetici (slabi i jaki) te adjuvantnu terapiju. Za olakšavanje proceduralne boli u novorođenčadi i dojenčadi mogu se koristiti oralna glukoza ili saharoza, a osim toga u sve djece za proceduralnu bol koriste se topikalne i injektibilne formulacije lokalnih anestetika.
Abstract (english) Clinical approach and evaluation of pain in children includes the following: determining the type and character of pain, determining the source, location, associated signs and symptoms and severity assessment. Moreover, it is necessary to determine the onset of pain and its duration. Pain can be classified by the type as: nociceptive, neuropathic and nociplastic. Every type of pain is associated with a specific character: sharp, dull, squeezing, stabbing, cramping, burning, throbbing etc. Source and location of pain can help to determine its aetiology while associated signs and symptoms can narrow down the differential diagnose and indicate the most likely one. Severity assessment depends upon the child's age and cognitive ability. Two methods are used for severity assessment: First, self-reporting, which include age-appropriate pain scales and questionnaires, adequate for children who are able to understand, quantify and visualise pain. Second, the behavioural-observation method, which observes physiological parameters and behaviour of the child, which is adequate for children who cannot self-report and nonverbal children. Treatment of pain includes both, nonpharmacological and pharmacological methods. Nonpharmacological treatment consists of physical, behavioural and cognitive methods. Pharmacological treatment is most often performed according to the World Health Organisation Analgesic Ladder. It includes the following agents: nonopioid analgesics (paracetamol and NSAID), opioid analgesics (weak and strong) and adjuvant therapy. Procedural pain in newborns and infants can be relieved with oral glucose or sucrose, but topical and injectable formulations of local anaesthetics are indicated in all children.
Keywords
bol
djeca
pristup
evaluacija
intenzitet
samoprocjena
liječenje
analgetici
Keywords (english)
pain
children
approach
evaluation
severity
self-report
treatment
analgesics
Language croatian URN:NBN urn:nbn:hr:184:065653 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2022-06-21 08:17:29
