Anaesthetists Handbook - MEDICAL EDUCATION at University ...

Pain management and postoperative carePaediatric acute pain medication[Sr Sue Millerchip, Dr Suja Chari, Ms Val Madden, July 2005;reviewed 2009]Paediatric pain dosage guidelinesThe doses in this guide are for guidance only and should be used incombination with the appropriate formulary, e.g. Medicines forChildren and the BNF for Children.Reassess pain periodically using the pain assessment tool and steptreatment up or down as below.DosesThe doses above are for inpatient treatment of acute pain and fordischarge following admission to a ward. SEEK ADVICE IF PAINNOT ADEQUATELY CONTROLLED- PAIN TEAM, SENIORPAEDIATRIC OR ANAESTHETIC STAFF MAY INCREASE DOSE orFREQUENCY. Note in particular that there is no ceiling dose formorphine and dose or frequency may be increased with appropriatemonitoring.Discharge medicationChildren treated under a PGD or supplied medication by nursing staffusing pre-labelled supplies will received age related instructions. SeePGD or BNF for dosesDoses on discharge when supplies are made from the pharmacydepartments will be rounded slightly up or down to facilitatemeasurement. See chart.Combination therapyIt is safe to combine paracetamol, non-steroidal drugs together withcodeine or morphine. If a patient is experiencing acute pain pleaseensure that both paracetamol and NSAID are given regularly ifappropriate. Do not alternate doses as there is no evidence that thisreduces side effects and may not give adequate analgesia. Codeineand morphine should not be given at the same time - however note100 Anaesthetists Handbook January 2010