Pharmacological pain management in pediatric intensive care

Pain syndrome is a condition which is highly prevalent in children and adolescents hospitalized in intensive care units. Despite the availability of a wide range of analgesic medications, pain syndrome is often under-diagnosed in the hospital setting and its manifestations are poorly managed, leading to long-term negative outcomes. This literature review presents the outcomes of pediatric pain syndrome treatment achieved in the clinical practice with different types of analgesic medication, such as paracetamol, non-steroidal anti-inflammatory drugs (ibuprofen, ketorolac, ketoprofen), and opioid analgesics (morphine, codeine, tramadol, fentanyl). There is an additional discussion of ketamine is an NMDA antagonist and nitrous oxide is a drug for general anesthesia. For each analgesic discussed, the review provides its advantages and disadvantages, as well as indications for use, from the perspective of evidence-based medicine. The properties of the analgesics are presented in a way that makes them easier to compare. For each drug, the typical dosages are listed, along with the routes of administration and the most important side effects when used for the treatment of pain syndrome in children and adolescents. The presented literature review demonstrates that a wide variety of analgesic medications are used in pediatric practice, and the clinician needs to clearly understand what indications exist for prescribing, routes of administration and doses of the main drugs used for pain relief — this knowledge will improve the quality of medical care for this condition.