Introduction to simple analgesia

Children's Inpatient Management of Pain Service (ChIMPS)

The management of pain relief should be based on the child's individual requirements considering;

• age
• cognitive ability
• motor skills
• parental support
• type of surgery and anaesthetic techniques

The aim of the treatment of pain is to provide adequate analgesia to ensure children experience the least discomfort with the minimum of side-effects, as this is the true end point of therapy.

Ideally analgesia should be discussed with the child and parent prior to commencing.

It is difficult to treat pain effectively if it is not assessed regularly; all children must have routine pain and sedation assessment. Over-sedation is an early sign of impending respiratory depression, and must be recognised and treated.

A multimodal approach to analgesia is better than relying on one specific treatment. Generally it is better to give analgesics regularly rather than wait for the child to complain of pain; this is particularly true for oral analgesics such as NSAIDs and paracetamol.

Analgesia should be prescribed orally unless a child cannot tolerate oral intake. A wide range of analgesics can be administered orally, from mild analgesics to more powerful opioids. Please see next page for basic Basic principles of prescribing oral analgesics

Be aware that diclofenac suppositories must not be cut in an attempt to give part of a suppository dose. This is because the amount of active drug may not be evenly distributed within the suppository.