Table 5 Drugs used and their posology [19]

Acetaminophen

po: 20 mg/kg initially, then 15 mg/kg every 4-6 h

rectal: 30–40 mg/kg initially, then 15–20 mg/kg every 4-6 h

ev: weight < 10 kg: 7.5 mg/kg every 6 h

weight > 10 kg: 15 mg/kg every 6 h

Maximum dose: 90 mg/kg/day (60 mg/kg/day if present risk factors)

NSAIDS

Low Power

 Ibuprofen

po: < 6 months: 5 mg/kg every 6-8 h

6 months: 10 mg/kg every 6-8 h

rectal: weight > 6 kg, 60 mg suppository every 8 h

weight > 12 kg, 125 mg suppository every 8 h

Maximum dose: 40 mg/kg/day

 Ketoprofen

po, rectal or ev: 3 mg/kg every 8-12 h

Maximum dose: 9 mg/kg/day

Moderate Power

 Naproxene

po: 5–10 mg/kg every 8-12 h

Maximum dose: 20 mg/kg/day

 High Power

 Ketorolac

po: 0.2 mg/kg (max 10 mg) every 4-6 h

ev, im: 0.5 mg/kg start, then 0.2–0.3 mg/kg every 4-6 h

Maximum dose: 3 mg/kg/day

 Indometacin

po, ev: 1 mg/kg every 8 h

Maximum dose: 3 mg/kg/day

OPIOIDS

Weak Opioids

 Codeine

po, rectal: 0.5–1 mg/kg every 4–6-8 h

ATTENTION:

NO if < 12y-old

NO for 12–18 y-old if:

 Recent tonsillectomy and or adenoidectomy;

 Ultra-rapid metabolizer CYP2D6;

 Bad respiratory function

 Tramadol

po: 0.5–1 mg/kg every 4–6-8 h

ev: 1 mg/kg every 3-4 h

ev: continuous infusion 0.3 mg/kg/h

Strong Opioids

 Morphine

CLORIDRATE (ev):

 Bolus 0.05–0.1 mg/kg every 2-4 h,

 Continuous infusion 0.02–0.03 mg/kg/h

SOLFATE (po):

 Early release: 0.15–0.3 mg/kg every 4 h;

 Slow release: 0.3–0.6 mg/kg every 8-12 h

 Oxicodone

po: 0.1–0.2 mg/kg every 8-12 h

 Fentanyl

ev:

 Bolus 1–2 mcg/kg (max 5 mcg/kg with spontaneous breathing),

 Continuous infusion 0.1 mcg/kg/h

 Intranasal: 1–2 mcg/kg