Biobehavioral Measures for Pain in the Pediatric Patient

Mamoona Arif-Rahu, RN, PhD, CCRN; Deborah Fisher, RN, MS, CS, CPON; Yui Matsuda, RN, BSN


Pain Manag Nurs. 2012;13(3):157-168. 

In This Article


Assessment of pain in the noncommunicative pediatric population provides many challenges for health care providers and researchers. Results of the present literature review indicate many avenues for future studies, including validation in the pediatric population. Clinical implications of the use of objective markers for pain measurement in the noncommunicative pediatric patient may include improved individualized titration of analgesia, decreased physiologic stress response from inadequate analgesia, and avoidance of chronic pain conditions secondary to inadequate management of acute pain. Further research on pain assessment is needed in the pediatric population by using a variety of markers for pain. Additional studies of interest include comparison of chemical and mechanical biomarkers for pain with validated behavioral markers for pain in the pediatric population. One such study may measure the correlation between EEG, serum β-endorphin, and the FLACC behavioral pain assessment tool during painful stimulus. Implications for further research include opportunities to improve validity and reliability of these pain assessment tools by using advanced methods such as analyses of facial expression, spectrographic devices, neuromuscular activity, or chemical markers.


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