Goodbye to needles

Narrative review shows that the short‐term use of ketorolac is safe and effective in the management of moderate‐to‐severe pain in children

“…Pain relief needs to be provided reasonably quickly, and the oral route is not ideal in this setting for procedural sedation or analgesia, because there are often delays before the drug is absorbed in the small intestine and before the drug in plasma reaches its site of action. Alternative early analgesic administration delivery routes in young children, such as the intranasal route or the sublingual route, are available (49). A study by Neri et al (50) showed that a single dose of ketorolac administered through the sublingual route was as effective as sublingual tramadol for pain management in children with suspected fractures or dislocations and had fewer side effects.…”

“…Pain relief needs to be provided reasonably quickly, and the oral route is not ideal in this setting for procedural sedation or analgesia, because there are often delays before the drug is absorbed in the small intestine and before the drug in plasma reaches its site of action. Alternative early analgesic administration delivery routes in young children, such as the intranasal route or the sublingual route, are available . A study by Neri et al.…”

Palliative medicines for children – a new frontier in paediatric research

“…Administering medications to children should be as simple and non‐traumatic as possible. For example, children may not report breakthrough pain if they suspect that a needle will follow . Medicines are often administered in the community by parents or informal carers where the route of administration may need to be different to, but equally as effective as, what may be used in a hospital‐based acute care situation.…”

“…Clinicians need appropriate medicines to prescribe that are both effective and easy to administer by parents and carers in different settings, including rapidly effective, needlefree medication for breakthrough symptoms such as pain and nausea. [6] Children represent a variable and diverse subset of individuals from the neonate through to a young adult and factors that influence prescribing are distinct from adults. Physical development and age influence both drug effect and drug disposition, with age-related changes in pharmacokinetics and pharmacodynamics.…”

“…For example, children may not report breakthrough pain if they suspect that a needle will follow. [6] Medicines are often administered in the community by parents or informal carers where the route of administration may need to be different to, but equally as effective as, what may be used in a hospital-based acute care situation. The lack of available safe, effective and easyto-administer medications may limit the care that can be supported in the community and may be the very issue that forces parents to give up on their preferred place of care.…”