Affiliations: [a] Division of Pain Medicine, Departments of Anesthesiology and Critical Care Medicine, and Oncology, Johns Hopkins Hospital, 550 N. Broadway, Suite 301, Baltimore, MD 21205, USA | [b] Divisions of Pediatric Anesthesiology and Pain Medicine, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
Abstract: The treatment of pain in children, the elderly, and intensive care unit patients presents some unique problems. Here a unifying theme is emphasized: the difficulty in adequately assessing pain in patients who are often unable to communicate. Also addressed are the differences in pharmacokinetics and pharmacodynamics from neonates to the elderly. Finally, common pain syndromes in each group, the associated treatments, and recent controversies are discussed. Because of changing demographics, pain treatment for these groups will become increasingly important. Only in the past 10 years has pediatric pain been treated with the same energy as adult pain; application of the newest techniques still lags far behind these patients' adult counterparts. Pain treatment in the elderly will inevitably become a larger problem as our population ages. Finally, recent advances in technology enable us to sustain patients with increasingly severe illnesses. Thus, pain management in these special populations will take on progressively greater importance.
Keywords: Pain, pediatric, geriatric, intensive care unit
