The basic principles of overcoming the pain are:
• Provide oral analgesics, if possible.
• Give analgesics regularly, so that the child does not feel the recurrence of pain
• Give analgesics with increasing doses gradually or start with mild analgesics and proceed with a more powerful analgesic as needed before.
• Determine the dose for each child, because every child needs a different dose to get the same effect.
Use the following drugs as an effective pain reliever.
1. Local anesthesia: for pain in the skin or mucosal lesions, or as a result of a painful procedure.
• Lidocaine: apply ointment on the gauze on the wound before the child’s mouth to be fed; This will react within 2-5 minutes.
• TAC (tetracaine, adrenaline, cocaine): apply on gauze and place it on the wound; this is especially useful when suturing.
2. Analgesics: for mild and moderate pain (such as headaches, post-traumatic pain, and pain that is caused by spasm)
• Aspirin: Aspirin is not recommended as a first choice antipyretic because it is associated with Reye’s syndrome, a condition that is rare but serious that attacks the liver and brain. Do not give aspirin to children suffering from chickenpox, dengue fever and other hemorrhagic disorders.
• Anti-inflammatory non-steroidal.
3. Potent analgesics such as opiates: for moderate and very severe pain that does not respond to treatment with analgesics.
• Morphine, a strong pain reliever and it’s cheap: give orally or IV every 4-6 hours, or continuous infusion.
• Pethidine: give orally or IM every 4-6 hours.
• Codeine: give orally every 6-12 hours that is combined with non-opioids to strengthen.
Note: Do monitoring on the possibility of respiratory depression. If there is tolerance, the dose should be increased to get the same pain relief effect.
4. Other drugs: for specific pain, include diazepam for muscle spasm, carbamazepine for neuropathic pain, and corticosteroids (such as dexamethasone) for pain due to swelling due to inflammation that suppresses nerve.