Innovative Integrated Pediatric Pain and Palliative Care Program Featured on NPR “Shots”

Interior and exterior of UCSF Benioff Children's Hospital San Francisco

The innovative use of inpatient acupressure for intractable pediatric pain by the UCSF Integrated Pediatric Pain and Palliative Care Program (IP3) has been featured in the August 5, 2019 issue of “Shots,” NPR’s health news blog. 

Expanding the Options for Managing Pediatric Pain

Concerns about the dangers of opioid use, the need to effectively address acute pain, and the long-term health effects of experiencing chronic pain tend to be heightened when treating children. Among the complicating factors: Families and clinicians worry about the effects of both drugs and pain on the developing brain and, for clinicians, working effectively with concerned families is essential, but requires much more than technical expertise. According to Amber Borucki, MD, the Director of Pediatric Anesthesia Pain in the IP3 Program at UCSF, “managing acute and chronic pain in children demands sensitive, multidisciplinary and coordinated care across inpatient and outpatient settings.”

“We include all the disciplines and emphasize communication because there are often co-morbid conditions associated with pain,” says Borucki. “Psychiatry, for example, can be very important because pain can lead to depression – and depression or anxiety can increase pain levels.” Similarly, patients and families concerned about the side effects and long-term effects of drugs, might turn to alternatives like physical or massage therapy and acupressure and other rehabilitation techniques like mindfulness and music or art therapy. And when drugs are necessary, in some cases it makes more sense to turn to interventional procedures for administering them. 

“Whether it’s cancer patients or those with non-malignant pain syndromes who have failed usual plans, chronic pain is not one more day of acute pain,” says Mark Schumacher, MD, PhD, Chief of the Division of Pain Medicine in the Department of Anesthesia and Perioperative Care. “It’s rare anyone will find one single cause or treatment. Our goal is to provide a plan that minimizes side effects and which allows patients to regain meaningful function.”

“And one of the nice things about working with kids is that they can be more open-minded about the alternative therapies,” says Karen Sun, MD, Chief of the Division of Pediatric Hospital Medicine and Associate Director of IP3.

Borucki adds that effectively working with families can also make a tremendous difference. “It can take some time to build trust, but when you have a good relationship, things tend to go much better, especially when people focus on functioning, not pain scores. Is the child going to school? Engaged in activities? Spending time with friends? Recent literature says that function is a better predictor of outcomes.”

Read the full NPR story here.

Read more about our IP3 work, here.

Visit the IP3 website, here.