Anaesthetists Handbook - MEDICAL EDUCATION at University ...

Pain management and postoperative careMORPHINE SULPHATE – moderate to severe pain with paracetamol and/orNSAIDSEEK ADVICE IF PAIN NOT ADEQUATELY CONTROLLED- PAIN TEAM,SENIOR PAEDIATRIC OR ANAESTHETIC STAFF MAY INCREASE DOSE orFREQUENCY NOTE NO CEILING DOSE FOR MORPHINE FOR PAINRELIEFChildren prescribed IV/ SC morphine for acute pain should have naloxoneprescribed 10µg/kg to be repeated as necessarySeek senioradvice forbabies under3monthsBirth – 1month1 – 3monthsMonitor closely: widevariation in response3- 6months 6months –1 year12 years12-16years ifless than50kg12 – 16years ifmore than50kgOral100 µg/kg4 hourly200 µg/kg4 hourly200 µg/kg4 hourly200 µg/ kg4 hourly200 – 400µg/kgMax 10mg10 – 15mg2 hourly3 hourlyIV bolus 25-100µg/kg4 hourly50-100µg/kg4 hourly100 µg/kg4 hourly200 µg/kg4 hourly200 µg/kgMax 10mg3 hourly5 – 10mgMax 10mg2 hourlyIV infusionLoad withbolus doseInstructionsnext sheetStart 10µg/kg/hup to20µg/kg/hStart 10µg/kg/hup to30µg/kg/hStart 10µg/kg/hup to30µg/kg/hStart 20µg/kg/hup to30µg/kg/hStart 20µg/kg/hup to30µg/kg/hStart 20µg/kg/hup to30µg/kg/hSC BolusNotrecommended150 µg/kg 150 µg/kg 150 µg/kg 200 µg/kg 5 – 20mgPCA may be available. Seek guidance from pain control team / pharmacy andsee separate guidelinesAnaesthetists Handbook January 2010 105