- The Society for Pediatric Anesthesia has published guidelines for the administration of opioids in pediatric patients during the perioperative period.
Why this matters
- There are few evidence-based reports offering guidance on opioid use in children in the perioperative period.
- No increased risk of respiratory distress because of opioids for term infants (>3 months) compared with older children and adults at the same blood concentration of opioid.
- Intramuscular administration of opioids is not recommended for primary pain control.
- Meperidine is not recommended for patient-controlled analgesia postoperative pain control because of increased risk of accumulation of toxic metabolites that may cause seizures.
- Codeine is not recommended for children and nursing mothers as a postoperative analgesic, and tramadol may not be appropriate for patients <12 years and other specific groups of pediatric patients.
- Opioid weaning in patients with chronic pain who undergo surgery to remove the source of the pain should be monitored by pain medicine specialists.
- Opioid dosing in patients with obstructive sleep apnea (OSA) and/or obesity should be based on ideal or lean body weight, and the dose of opioid should be reduced by 50%-67% for OSA patients.