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March 14, 2017

The ESPA Pain Ladder Initiative UPDATE

The Pain Ladder Initiative was founded in 2014 by the ESPA Pain Committee which was chaired by Per-Arne Lönnqvist. The…

The Pain Ladder Initiative was founded in 2014 by the ESPA Pain Committee which was chaired by Per-Arne Lönnqvist. The aim of this initiative is to improve postoperative pain therapy in paediatric patients throughout Europe. The main problems we are facing in postoperative pain management are the different drugs which are available and used in different countries – the result from this are the different levels of standard care throughout Europe. The basic idea of this Pain Ladder Initiative is to define a minimum standard of postoperative analgesic care which should be provided even in the smallest hospital with restricted resources. Once the initiative completes this basic level, the Pain Ladder is also intending to give suggestions for postoperative pain therapy at intermediate and advanced levels.

Following this scheme and based on the current literature, the ESPA Pain Ladder for Inguinal Hernia Repair was created by the core team of the ESPA Pain Committee. Following this, members of ESPA were invited to join this Pain Ladder Project and volunteer to participate in creating five more Pain Ladders for typical paediatric surgical procedures. These procedures are:

Pyloromyotomy

Adeno-Tonsilectomy

Appendectomy

Circumcision

Limb Fracture

Five ESPA member teams have been busy discussing their suggestions for the above-mentioned Pain Ladders and the first drafts were presented by the ESPA Pain Committee at the ExBo Meeting in February 2016 in Praque. In the following month, the ESPA Pain Committee reviewed these drafts and now, the first six Pain Ladders are getting ready for publication.