I.V. fentanyl PCA is as effective as thoracic epidural for postoperative analgesia in children after thoracoscopic pectus excavatum repair. Bearing in mind the possible complications of epidural catheterization in children, the use of fentanyl PCA is recommended.

Laser acupuncture is equally effective as metoclopramide in preventing PONV in children.

Summary Gabapentin is an antiepileptic drug indicated for the treatment of partial seizures in children. Many studies have proved its analgesic action in the treatment of neuropathic pain in adults and we have noticed an analgesic action of gabapentin in neuropathic pain in children. Five patients treated in the Children's Hospital Pain Control Service for intractable neuropathic pain were included in gabapentin treatment. Four were cancer patients and one suffered from neuropathic pain in the neck (C3). The visual analog scale (VAS) scores of pain were compared before and during treatment with gabapentin. We noticed a rapid improvement, in 1 week, of our patients' VAS scores (from 9 or 10 to 4 or 3) with minimal adverse effects. In the follow-up period of 6 months we gradually reduced the dose of gabapentin. Our findings are that gabapentin should be included earlier in the treatment of neuropathic pain in adolescents, because it rapidly improves analgesia and has minimal side effects.

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Melatonin is a hormone secreted 80% by epiphysis and 20% by extrapineal structures. It performs several functions including chronobiotic, antioxidant, oncostatic, immune modulating, normothermal, and anxiolytic functions.There are numorouse studies demonstrating melatonin efficacy in relation to chronic pain syndromes. The present paper reviews the studies on melatonin use in various forms of headaches, and chronic back pain.The paper discusses the possible mechanisms of analgesia. Circadian rhythm normalization results in sleep improvement, which is disordered in chronic pain syndromes,hence there is evidence of melatonin-independent analgesic effect involving melatonin receptors.