Alleviating children

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“Being able to turn a tough medical test situation into something positive for a child who hardly dares walk through the door is an incredible feeling,” says Stefan Lundeberg, who has been part of the Pain Relief Unit for Children since its start.

Providing pain relief after an operation, during examinations, tests, serious illnesses and chronic pain is the mission of the Pain Relief Unit for Children at Karolinska University Hospital. This year, the unit will be celebrating its 25th anniversary.
Since its opening in 1993 at St. Göran's Hospital, the Pain Relief Unit has gathered expertise and developed routines which, today, are sought after by other hospitals in Sweden.

"We have become a knowledge center. No other hospital in Sweden has our resources," says Stefan Lundeberg, Chief Physician at Pain Treatment Service.

Pain Treatment Service's story began when a nurse, Leena Jylli, contacted Stefan Lundeberg because she believed that children's post-operative pain treatment needed to be improved.

"In the middle of the 1980s knowledge of children's pain changed. Previously, little was known. Pain treatment for children was minimal and the drugs that were administered were not optimally used," says Stefan Lundeberg.

Jylli and Lundeberg were awarded a grant from the County Council to visit international hospitals and institutions and return with increased expertise. After that, they opened the Pain Treatment Service as a project with a full-time nursing position and a half-time doctor's position. Today's team consists of three full-time doctors and three fulltime nurses in Solna and one fulltime doctor and one and a half nursing positions in Huddinge.

"We are a small group that has worked together for a long time, which forms a breeding ground for a lot of ideas and curiosity. Everyone has a background in anesthesiology, which enables us to dare to try new methods," says Stefan Lundeberg.

For example, they have developed a nose spray that helps with different painful treatments or examinations. And another nose spray that quickly stops sedation oncethe procedure is over.

We have become a knowledge center. No other hospital in Sweden has our resources.

The unit essentially works throughout Astrid Lindgren's Children's Hospital: they ease and prevent post-operative pain in children, reduce pain during procedures (needle sticks, sample taking, painful examinations), help children with pain due to severe medical conditions, complex pain or pain during palliative care (end-stage care for terminally ill patients).

Much of the development work concerns creating as safe and secure an environment as possible for both the children and their family members.

"Training, routines and safety of pain treatment is a major part of our work at the hospital, as well as a challenge, as personnel turnover is high.

There are not a lot of new drugs for treating pain, explains Stefan Lundeberg. Instead, you try to improve treatment by using pre-existing drugs in the best way. Multimodal treatment, which is a combination of different drugs, has been shown to reduce pain and side effects.

Stefan Lundeberg compares pain relief to spicing a stew:
"Adding a little bit of something can make all the difference. When you make it for work for a patient you feel – nailed it!

Text and Photo: Catarina Thepper