Investigation of Hyperacusis in Patients with Tinnitus.

Acute pain in children represents a critical component of clinical care, with significant implications for both short- and long-term outcomes. Inadequate pain management has been associated with increased procedural anxiety, behavioral changes, and long-lasting neurobiological alterations [,,]. It is now well established that inadequate pain control in early life may negatively influence the healthcare experience, increase procedural anxiety, and contribute to persistent behavioral and neurobiological alterations [,,]. Despite the wide availability of validated assessment tools and therapeutic options, the literature highlights significant heterogeneity in approaches to pediatric pain, with frequent delays in assessment, underestimation of pain intensity, and suboptimal use of analgesic strategies [,,]. Observational studies conducted across various clinical settings report that pain in children is still frequently under-recognized or inadequately treated, particularly in emergency and inpatient settings [,,], but also in out-of-hospital contexts [,]. Moreover, although previous systematic reviews have addressed specific aspects of pediatric pain management, these reviews have generally focused on single interventions or specific clinical settings. To our knowledge, no recent review has integrated the available evidence across the principal domains of acute pediatric pain management using predefined PICO questions and the GRADE framework to support clinically oriented recommendations. This gap between recommendations and everyday clinical practice underscores the need for a systematic synthesis of the available evidence and for a structured framework to support the development of standardized practices. In response to this need, the present study aims to provide a systematic analysis of the literature on the management of acute pain in children and adolescents, structured around clinical questions formulated according to the PICO model. The objective is to critically integrate existing knowledge, identifying areas of evidence while also identifying the gaps that persist in pediatric acute pain research.