Background: Acute pain is one of the most common presenting complaints in pediatric
patients presenting to the emergency department. Recently, concern about the safety of narcotics
such as codeine has sparked a renewed interest in opioids such as morphine and intranasal fentanyl.
Objectives: Consequently, opioids are being increasingly used in the clinical setting. Despite this,
there is ample evidence that clinicians are less willing to offer opioids to children compared to
Methods: The reasons for this are multifactorial but nevertheless, the provision of adequate analgesia
in children is echoed by a several academic societies as a priority for comprehensive care. To
address this mandate, evidence for therapies such as oral morphine, topical analgesia, and intranasal
fentanyl is now mounting.
Result and Conclusions: This review will discuss the evidence and effectiveness of analgesia for
children with acutely painful conditions in the post-codeine era.