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The Role of Neuraxial Opioids in Pediatric Practice

Berger, Ardin S., DO*; Goldschneider, Kenneth R., MD

The Clinical Journal of Pain: June 2019 - Volume 35 - Issue 6 - p 497–500
doi: 10.1097/AJP.0000000000000706
Special Topic Series on Opioid Therapeutics and Concerns in Pediatrics

Neuraxial-spinal and epidural-administration of opioids can be an effective method for controlling pain for children in a number of clinical settings. Understanding the basic pharmacologic and logistical concepts will make it easier for pediatricians to advocate for their patients, and support patients and families when circumstances suggest that neuraxial opioid treatment is appropriate. This review article summarizes the basic concepts of pharmacology, drug choice, side effects, and complications as well as situations in which neuraxial opioids are appropriate in children.

*Department of Anesthesiology, Perioperative & Pain Medicine, Stanford University School of Medicine, Stanford, CA

Department of Anesthesiology, Clinical Pediatrics and Anesthesia, Pain Management Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH

The authors declare no conflict of interest.

Reprints: Kenneth R. Goldschneider, MD, Clinical Pediatrics and Anesthesia, Director, Pain Management Center, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, ML #2001, Cincinnati, OH 45229-2029 (e-mail:

Received January 10, 2019

Received in revised form January 13, 2019

Accepted January 15, 2019

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