PURPOSE OF REVIEW This review highlights the current trends of efficient and safe perioperative pediatric pain therapy in the context of a multimodal pain therapy concept. RECENT FINDINGS A multimodal pain therapy concept should be easy to apply and safe regarding the occurrence of sideeffects. The administration of nonopioid analgesics should be obligatory, regional anesthesia techniquesunder ultrasound guidance -should be performed whenever possible, opioids should be given immediately and sufficiently whenever necessary, the administration of co-analgesics like lidocaine, dexamethasone or ketamine should be considered, and most importantly, each pain therapy should be performed according to pain assessment and long enough until adequate pain relief. SUMMARY Safe and simple pediatric pain management in the perioperative period combines not only easy to apply and safe stepwise pain therapy itself, but also adequate pain assessment and the implementation of continuous hospital quality improvement strategies. Purpose of reviewThis review highlights the current trends of efficient and safe perioperative pediatric pain therapy in the context of a multimodal pain therapy concept. Recent findingsA multimodal pain therapy concept should be easy to apply and safe regarding the occurrence of side-effects. The administration of nonopioid analgesics should be obligatory, regional anesthesia techniques -under ultrasound guidance -should be performed whenever possible, opioids should be given immediately and sufficiently whenever necessary, the administration of co-analgesics like lidocaine, dexamethasone or ketamine should be considered, and most importantly, each pain therapy should be performed according to pain assessment and long enough until adequate pain relief. SummarySafe and simple pediatric pain management in the perioperative period combines not only easy to apply and safe stepwise pain therapy itself, but also adequate pain assessment and the implementation of continuous hospital quality improvement strategies.

Efficient and safe pediatric perioperative pain therapy in the context of a multimodal pain therapy concept requires a slight to moderate opioid analgesic. Nalbuphine is a nearly ideal opioid for this purpose due to its unique pharmacological properties as a μ-receptor antagonist/κ-receptor agonist and a high safety profile. Nalbuphine is used clinically primarily in postoperative pain therapy administered as a bolus, continuous infusion and patient-controlled analgesia. Furthermore, it is administered in different regimens for pediatric diagnostic and interventional sedation.