Introduction Despite numerous advances in the management of acute pain in adults patients in the last two decades, acute pain in children have received only limited attention. Many children do not receive any opiod analgesics after surgical procedures, despite the fact that the postoperative courses are known to be painful. In addition, children often undergo invasive painful procedures without adequate analgesia. Children cannot localise or describe their pain.
Respiratory depression occurs frequently after opiod administration.
Fear to develop addiction to opiates. There is little variation in pain intensity following the same procedure in different children or even in the same child in different occasions. Pain is character building for children. This may explain why in the infant a specific noxious input does not give a predictable and consistent response and that noxious stimuli may subsequently alter the sensitivity of that infant to non-noxious stimuli. Opiod receptors are present and functional from early in development, and they are able to change both in numbers and in receptor type affected by opioid exposure even in utero .