Brill J E
Department of Pediatrics, University of California, Los Angeles, School of Medicine.
Crit Care Clin. 1992 Jan;8(1):203-18.
Pain in critically ill and injured pediatric patients may go unrecognized and undertreated since children often suffer silently and caretakers are often fearful to intervene aggressively to alleviate pain. Methods are now readily available to relieve pain in the vast majority of ICU patients. Administration of inadequate doses of opioids at infrequent intervals or via a noxious route (intramuscularly) can be supplanted by far superior pain management methods. Provision of nearly constant therapeutic levels of opioid via a painless route is recommended and will usually be well tolerated even by very sick children. This can be achieved by the use of continuous intravenous infusions of opioids, PCA, or epidural administration of local anesthetics or opioids. Flexibility is essential so that the appropriate technique or agent can be selected for a particular pediatric ICU patient.
