An update of systemic analgesics in children

Effective and safe pain management in children can be complex and challenging. It remains an important goal in order to minimize acute distress, behavioural changes, central sensitization and hyperalgesia. Neonates are particularly susceptible to long-term neurodevelopmental changes due to the neuroplasticity of their immature brains, and adequate analgesia may help ameliorate these changes. The focus of this review is to look at systemic analgesic options available for children, infants and neonates. This review includes a brief description of important pharmacokinetic, pharmacodynamic and pharmacogenomic issues that can influence the effectiveness and safety of these medications, whilst highlighting the impact organ-immaturity in neonates can have on pain processing and analgesic pharmacology.