Current guidelines for the treatment of acute pain in children.

Premature and full-term neonates, infants and children are capable of experiencing pain just like adults, and deserve aggressive treatment. Assessment of pain is difficult in the preverbal group. However, physiological and behavioural responses to noxious stimuli are well developed even in the fetus, and modifying these responses through treatment can affect outcome. Treatment options include systemic opioid and nonopioid analgesics as well as local anaesthetics, all of which are effective when chosen on the basis of the type and intensity of the pain. Dosage modification is necessary based on age and organ function. Nonopioid analgesics are useful supplements to reduce opioid analgesic dose and should be used when indicated. Drug dependence and withdrawal can be avoided by using the opioids appropriately and following logical weaning schedules after long term use of these agents. Use of needles for administering analgesia is still an intimidating part of the process for young children. The development of drugs having fewer adverse effects and noninvasive administration techniques will be important research priorities in the future.