Authors: Joseph P. Cravero, M.D., FAAP et al
ASA Monitor 11 2016, Vol.80, 28-30.
Opioids represent one of the time-honored tools for pediatric anesthesiologists in treating the most significant pain and suffering that confront our patients. While we continue to seek adequate pain treatment and avoid the consequences of inadequately treated pain, the reality of the ongoing epidemic of opioid abuse and addiction is a significant issue that demands our attention. At the same time, pediatric anesthesiologists must deal with the complexity (and vulnerability) of the population we treat, including infants who face dependence because of maternal opioid abuse or ICU sedation requirements, children with chronic pain conditions and adolescents who find access to medications in the family medicine cabinet. In response to the evolving issues related to opioid treatment in children, the Society for Pediatric Anesthesia (SPA) and the Society for Pediatric Pain Medicine (SPPM) have engaged a group of experts to formulate evidence-based guidelines for opioid use in the perioperative time period. These recommendations are specifically meant to serve as a resource for anesthesiologists and provide some guidance for the increasingly controversial question of how opioid therapy should be delivered. The expert panel also strongly believes there is a need to balance advocacy for appropriate access to opiate therapy with an appreciation of the current flaws in pain assessment for children and the need to appreciate signs of pediatric patients at risk for addiction. ASA and SPA are looking forward to partnering with other interested parties and organizations to fully vet the document and be sure that the resulting recommendations recognize the (sometimes opposing) need to provide pain relief with the effort to control abuse and misuse.