Acute Pain Management in Children
Children’s pain may be difficult to recognize and to measure reliably. Pain assessment tools must be age and developmentally appropriate because children’s understanding and ability to describe pain changes as they grow. The options available to manage pain also vary with age. Non-pharmacological strategies supplement analgesic drugs and are especially useful for procedural pain. The metabolism of analgesic drugs matures during growth, affecting doses in neonates and infants. Some drugs that are useful analgesics in adults cannot be used in children because they are not available in liquid form for oral dosing. Morphine is the most widely studied and used opioid in children. Morphine metabolism is reduced in neonates and infants, and the incidence of respiratory depression from opioids is almost ten times more in neonates than adults. Intravenous opioids are the preferred route for the management of severe pain. Intravenous infusions for children are made up differently to those for adults—the concentration in the syringe varies with the weight of the child, but the volume administered is similar regardless of age. This standardizes volume independent of age and weight, and staff can see the infusion rate and are able to place the dose into context of the dose range usually given to children. Children aged 6 years and older are usually able to use patient controlled analgesia, but unlike adults, background infusions improve analgesia, promote sleep and do not increase adverse effects in children with severe and constant pain.
KeywordsPediatric pain tools Morphine metabolism children Opioid infusions children Paracetamol in neonates Nurse controlled opioid infusions Patient controlled analgesia in children
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Pain After Day Surgery
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