Novel concepts for analgesia in pediatric surgical patients. Cyclo-oxygenase-2 inhibitors, alpha 2-agonists, and opioids.
Pain has been an understated concern in infants and children. Failure to recognize pain in the past has resulted in undue suffering by infants and children of all ages, but with the introduction of instruments to measure pain and a widespread appreciation of the severity of this problem in this age group, pain is rapidly coming under control. Novel concepts in both old and new analgesics have created safe and effective pain management strategies for infants and children. This review examines three analgesics and their potential roles in infants and children: cyclo-oxygenase (COX)-2 inhibitors, alpha 2-agonists and opioids.
Farrar
Mark W
MW
Department of Anaesthesia, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Lerman
Jerrold
J
D058669:Adrenergic alpha-2 Receptor Antagonists; D000317:Adrenergic alpha-Antagonists / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000818:Animals; D002648:Child; D002675:Child, Preschool; D051545:Cyclooxygenase 1; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007527:Isoenzymes / Q000378:metabolism*; D008565:Membrane Proteins; D010149:Postoperative Pain / Q000188:drug therapy*; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism*
D058669:Adrenergic alpha-2 Receptor Antagonists; D000317:Adrenergic alpha-Antagonists; D000701:Analgesics, Opioid; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D008565:Membrane Proteins; D051545:Cyclooxygenase 1; D051546:Cyclooxygenase 2; C496511:PTGS1 protein, human; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases