Opioid analgesia
| Route | Dose | Analgesic potency | Respiratory depression | Approximate cost (one dose to 20 kg child)* | Comments | |
|---|---|---|---|---|---|---|
| *Source British National Formulary, March 1999. | ||||||
| Codeine | oral | 1 mg/kg; 4–6 hrly | mild–moderate pain | + | 5p | Not advised IV: risk of histamine release and anaphylaxis |
| Morphine | oral/rectal | 0.2–0.4 mg/kg | oral; 9p | poor oral bioavailability; nausea; anxiolytic | ||
| prn, 4 hrly | severe pain | ++ | rectal; 50p | Slow IV bolus; titrate against response | ||
| IV | 0.1–0.2 mg/kg | IV; 60p | ||||
| prn, 4 hrly | ||||||
| Diamorphine | IV | 0.08 mg/kg | IV; £1.10 | shorter duration of action than morphine; less nausea | ||
| prn 4 hrly | severe pain | ++ | ||||
| oral | 0.1–0.2 mg/kg | oral; 12p | ||||
| prn 4 hrly | ||||||
| Fentanyl | IV | 3–5 mcg/kg | severe pain | +++ | 24p | rapid onset, short acting |
| Pethidine | IV | 0.5–1.0 mg/k | moderate pain | ++ | IV; 10p | Short duration of action |
| oral | 0.5–2.0 mg/kg | oral; 5p | Nausea | |||