Systemic analgesics in children – update

A multimodal analgesic approach is key to providing safe and effective analgesia in children. The use of age-appropriate pain scoring systems with regular monitoring and pain assessment is essential to guide treatment and to achieve optimal pain control, while ensuring safety and minimizing unwanted effects.Due to neuroplasticity of immature pain pathways, pain in early life has been shown to lead to heightened sensitivity to pain on future exposure. Effective pain control has therefore the dual benefit of good analgesic control during an episode of pain, as well as reducing the potential for longer term pain pathway neurodevelopmental changes.An understanding of the developmental changes in pharmacokinetics and pharmacodynamics of analgesic drugs in neonates, infants and children is key to safe and effective dosing of analgesic agents across this age range. Considerations for safe and effective use of paracetamol, non-steroidal anti-inflammatory drugs opioids and adjuvant analgesics in children will be discussed.