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Pharmacological Treatment of Chronic Non-Cancer Pain in Pediatric Patients

机译：小儿慢性非癌性疼痛的药理治疗

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摘要

Chronic pain in children and young adults occurs frequently and contributes to early disability as well as personal and familial distress. A biopsychosocial approach to evaluation and treatment is recommended. Within this approach, there is a role for pharmacologic intervention. A variety of medications are used for chronic pain conditions in pediatric patients. Medication classes include anticonvulsants, muscle relaxants, antidepressants, opioids, local anesthetics, and anti-inflammatory drugs. Data is sparse, and most medications are used without condition-specific approval by national regulatory agencies such as the Food and Drug Administration in the US and the European Medicines Agency. In the absence of evidence on which to base practice, optimal drug therapy decisions rest on understanding proposed mechanisms of pain conditions, extrapolation from adult data-when such exists, and empirical and experiential knowledge. Drug delivery systems have evolved, and practitioners have to decide amongst not only medication classes, but also routes of delivery. Opioids are not recommended for use by non-pain specialists for the treatment of pediatric chronic pain, and even then the issues are more complex than can be addressed here. This article reviews the major medications used for pediatric chronic pain conditions.
机译：儿童和年轻人的慢性疼痛经常发生，并导致早期残疾以及个人和家庭困扰。建议采用生物心理社会学方法进行评估和治疗。在这种方法中，有药物干预作用。各种药物可用于小儿患者的慢性疼痛。药物类别包括抗惊厥药，肌肉松弛药，抗抑郁药，阿片类药物，局部麻醉药和抗炎药。数据稀疏，大多数药物未经国家监管机构（例如美国食品药品监督管理局和欧洲药品管理局）的特定条件批准而使用。在缺乏实践依据的情况下，最佳药物治疗决策取决于了解疼痛状况的拟议机制，从成人数据中推断（如果存在）以及经验和经验知识。药物输送系统已经发展，从业人员不仅要在药物类别中做出决定，而且还要在给药途径中做出决定。非疼痛专家不建议使用阿片类药物治疗小儿慢性疼痛，即使这样，问题也比这里要解决的更为复杂。本文介绍了用于儿童慢性疼痛病症的主要药物。

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