Pharmacologic Modalities

The choice of a pharmacologic agent for a pediatric patient's pain management should consider the nature of the procedure, the duration of the procedure, and the most appropriate route of administration. It should be made in conjunction with nonpharmacological techniques. Pharmacologic analgesic therapy can be systemic (opioids and nonopioids), or nonsystemic (local anesthetic agents with topical, local, or regional administration). There is a continuum between systemic analgesia and sedation. When narcotics are used, closely monitor patients, precalculate the appropriate dose of naloxone, and have resuscitation equipment readily available

Suggested systemic medications, dosages, routes of administration, and comments for non-opioid analgesics are outlined in Table 13.0.-9 and for opioids in Table

130-10. Nonsystemic medications and techniques for administration, such as local anesthetic (LA) topical, local and regional procedures are discussed in detail in Chap 32.

TABLE 130-9 Non-Opioid Analgesics
TABLE 130-10 Opioid Analgesics

Avoidance of painful intramuscular and subcutaneous injections is particularly important when treating children. The intravenous route is recommended for titration of narcotic medications. Noninvasive topical or mucosal techniques for the delivery of systemic pharmacologic agents should be used where appropriate.

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