Analgesia for Children in Acute Pain in the Post-codeine Era

Naveen Poonai, Rongbu Zhu

Acute pain is one of the most common presenting complaints in pediatric patients presenting to the emergency department. Recently, concern about the safety of narcotics such as codeine has sparked a renewed interest in opioids such as morphine and intranasal fentanyl. Consequently, opioids are being increasingly used in the clinical setting. Despite this, there is ample evidence that clinicians are less willing to offer opioids to children compared to adults. The reasons for this are multifactorial but nevertheless, the provision of adequate analgesia in children is echoed by a several academic societies as a priority for comprehensive care. To address this mandate, evidence for therapies such as oral morphine, topical analgesia, and intranasal fentanyl is now mounting. This review will discuss the evidence and effectiveness of analgesia for children with acutely painful conditions in the post-codeine era.