Opioid Use in Children

Pain and sedation in critically ill children:

One-third of children experience inadequate pain control in the pediatric intensive care unit and 74% of children have recalled their painful experiences in the pediatric critical care unit. Opioids effectively treat moderate to severe pain and provide sedation in children; however, their efficacy diminishes over time due to the development opioid tolerance. Dose escalation that follows opioid tolerance leads to opioid-associated iatrogenic withdrawal syndrome, occurring in up to 65% of children with prolonged opioid exposure.

Currently, opioid tolerance is diagnosed after the dose escalation has occurred. Therefore, strategies to prevent opioid tolerance are difficult to study. We have piloted a study to utilize the immune response as potential biomarkers to identify risk of opioid tolerance and opioid-associated iatrogenic withdrawal syndrome. Our investigations focus on identifying strategies that reduce overall opioid exposure and opioid-related adverse effects in children.