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The Use of Opioids for Treatment of Pediatric Neuropathic Pain

A Literature Review

Windsor, Robert B., MD*,†; Tham, See Wan, MBBS‡,§; Adams, Trevor L., MD‡,§; Anderson, Annette, ARNP§

The Clinical Journal of Pain: June 2019 - Volume 35 - Issue 6 - p 509–514
doi: 10.1097/AJP.0000000000000712
Special Topic Series on Opioid Therapeutics and Concerns in Pediatrics

Pediatric neuropathic pain is caused by a spectrum of disorders that are generally challenging to treat. Many of the underlying altered neurological processes are being elucidated through mechanistic studies. Few randomized control trials have evaluated the use of opioids for the treatment of adult neuropathic pain conditions, and there have been none in pediatric populations. With sparse data to provide guidance and an incomplete understanding of the underlying mechanisms, the use of opioids remains unclear. Our clinical experience and typical risk versus benefit considerations suggest a limited, if any, role for using opioids to treat pediatric neuropathic pain. In this literature review, we review the available adult and pediatric data and provide general guidance on this subject matter.

*Departments of Pediatrics and Anesthesiology, University of South Carolina School of Medicine Greenville

Department of Pediatrics, Children’s Hospital of Prisma Health-Upstate, Greenville, SC

Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine

§Department of Anesthesiology and Pain Medicine, Seattle Children’s Hospital, Seattle, WA

The authors declare no conflict of interest.

Reprints: Robert B. Windsor, MD, Department of Pediatrics and Anesthesiology, University of South Carolina School of Medicine Greenville, 1350 Cleveland St, Greenville, SC 29607 (e-mail:

Received March 14, 2019

Accepted March 14, 2019

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