thesis
Paediatric pain management: from personal-biased to evidence-based
- Publication date
- 30 October 2002
- Publisher
- In this study we have shown that neonates and infants up to I year of age may receive
intermittent morphine doses, thereby avoiding the excessive fluid intake and the need of
infusion equipment. Older infants (I - 3 years) may require either a continuous infusion,
or more frequent dosing regimens (every 1 - 2 hours) or judicious increases in the
intermittent doses used for postoperative morphine analgesia. We speculate that combined
therapy with different classes of analgesics and sedative drugs will provide more effective
control of physiological and behavioural responses, especially in toddlers 1 - 3 years of
age, who may have a high level of anxiety in the PICU environment. Further studies are
needed to establish the efficacy and safety of such combinations, i.e. morphine combined
with midazolam, paracetamol or a NSA!D. These studies will not only provide a scientific
framework for the postoperative management of neonates and young infants, but may also
provide clues to elucidate the development of pain and stress-responsive systems in the
developing brain.