Division of Pain Medicine
The Division of Pain Medicine at Boston Children's Hospital is the most clinically active program of its kind in the world. Since its founding in 1986, the program has been at the helm of research and innovation in pain management.
Our goal is to bring together clinicians and scientists to conduct innovative research and make fundamental discoveries about pain, anesthesia, and analgesia. We strive to train the next generation of scientists and clinicians, and to transform our ability to treat pain in childhood.
Our research includes behavioral studies, genetics, neural circuit architecture, computational modeling, imaging, medical/procedural interventions, and psychology. We have a number of innovative clinical and basic science research programs that are broadly grouped into four themes, although our division’s interdisciplinary approach means that many overlap:
A few accomplishments include:
- first ABA-accredited pain fellowship with a specific focus on pediatric pain
- first randomized controlled trial of patient-controlled analgesia in pediatrics
- first prospective controlled study of rehabilitative treatment of CRPS/RSD in pediatrics
- first study of normal reference ranges for quantitative sensory testing (QST) in healthy children and adolescents
- first study of sensory abnormalities in pediatric CRPS/RSD using QST
- first study of cardiovascular autonomic regulation in pediatric CRPS/RSD
- first study of brain imaging using fMRI in pediatric CRPS/RSD
- first case series on patterns of opioid dose escalation in pediatric advanced cancer
- first study of safety and recovery parameters for midazolam for sedation for pediatric oncology procedures
- first case series on regional anesthesia for refractory pain in children with advanced cancer
- first study of the safety of postoperative use of ketorolac in children
- first study using transfer function analysis of heart rate variability to examine cardiovascular autonomic regulation in infants undergoing hernia repairs under spinal anesthesia
- first randomized controlled trial of methadone for postoperative pain in children
- first study of the pharmacology of the local anesthetic 2-chloroprocaine in infants
- first randomized crossover trial of lumbar sympathetic lidocaine and intravenous lidocaine in pediatric CRPS/RSD
- first double-blind study using a crossover paradigm to establish steady state potency ratio of morphine to hydromorphone in children
Ongoing Research and QI Initiatives:
- Prolonged Local Anesthetic Action: Translational Research & Development of Novel Local Anesthetics
- Genetics of Chronic Pain
- Pediatric Interventional Pain Program Research
- Clinical Outcomes of Pediatric Chronic Pain Treatment
- Use of applications such as WeCOPE and Chat with Children’s for Long-term follow-up of Patients with Chronic Pain: A QI Initiative
- CRPS in Pediatrics: Epidemiology, Sensory Physiology, & Clinical Trials
- Effects of Opioids, Anesthetics & Prolonged Sedation in Developing Human Infants & Animals
- Spinal Muscular Atrophy Intervention Program
- Innovative Psychological Interventions for Pediatric Pain
- Sensory Processing
Pediatric Pain Medicine Fellowship Program
The Division of Pain Medicine offers fellowship training in pediatric pain medicine and pediatric psychology. The Pediatric Pain Medicine Fellowship is a one-year ACGME-accredited training program that offers in-depth training in both adult and pediatric pain medicine.
The pain medicine fellowship is a multidisciplinary program where fellows rotate through the following services: palliative care, regional anesthesia, interventional procedures, cancer pain, inpatient acute pain management, inpatient and outpatient chronic pain management, and pain rehabilitation program. Fellows are encouraged to participate in an independent research project or in one of the many ongoing research projects within the division under the mentorship of a senior investigator. The program also offers an extensive didactic series that include daily lectures in adult and pediatric pain medicine, journal clubs, case discussions, and online video of pertinent lectures.