Analgesic Regimens

Mild to moderate pain:

Acetaminophen with codeine

• Dose based on codeine—children: 1 mg/kg per dose every 6 hours; adults: 30-60 mg/dose

Hydrocodone + acetaminophen:

• Dose based on hydrocodone—children: 0.2 mg/kg per dose every 6 hours; adults: 5-10 mg/dose

Anti-inflammatory agents

• Use with caution in patients with renal failure (dehydration) and bleeding

• Ibuprofen: children: 10 mg/kg every 6-8 hours; adults: 200-400 mg/dose

• Naproxen: 5 mg/kg every 12 hours; adults: 250-500 mg/dose

• Ibuprofen + hydrocodone: Each tablet contains 200 mg ibuprofen and 7.5 mg hy-drocodone per tablet; only for older children who can swallow tablets

Moderate to severe pain:

Morphine—children: 0.1-0.15 mg/kg per dose every 3-4 hours; adults: 5-10 mg/ dose

• Continuous infusion: 0.04-0.05 mg/kg/h; titrate to effect

Hydromorphone—children: 0.015 mg/kg per dose every 3-4 hours; adults: 1.5-2 mg/dose

• Continuous infusion: 0.004 mg/kg/h; titrate to effect IV anti-inflammatory agents:

• Ketorolac: 0.5 mg/kg up to 30 mg/dose every 6 hours Patient-controlled analgesics:

• Morphine: 0.01-0.03 mg/kg/h basal; demand 0.01-0.03 mg/kg every 6-10 minutes; 4 hours lockout 0.04-0.06 mg/kg

• Hydromorphone: 0.003-0.005 mg/kg/h basal; demand 0.003-0.05 mg/kg every 6-10 minutes; 4 hours lock out 0.4-0.6 mg/kg

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