Multimodal analgesia in children

Myron Yaster, Richard J. Traystman

Research output: Contribution to journalReview articlepeer-review


Acute and chronic pain management in children is increasingly characterized by either a multimodal or a preventive analgesia approach, in which smaller doses of opioid and nonopioid analgesics, such as nonsteroidal anti-inflammatory drugs, local anaesthetics, N-methyl-D-aspartate antagonists, α2-adrenergic agonists, and voltage-gated calcium channel α-2 δ-proteins, are combined alone and in combination with opioids to maximize pain control and minimize drug-induced adverse side effects. A multimodal approach uses nonpharmacological complementary and alternative medicine therapies too. These include distraction, guided imagery, hypnosis, relaxation techniques, biofeedback, transcutaneous electrical nerve stimulation, and acupuncture. Using the neurophysiology of pain as a blueprint, the molecular targets and strategies used in multimodal pain management are described. Finally, weight-based dosage guidelines for commonly used opioid and nonopioid analgesics are provided to facilitate therapy.

Original languageEnglish (US)
Pages (from-to)851-857
Number of pages7
JournalEuropean Journal of Anaesthesiology
Issue number10
StatePublished - Oct 2010


  • Analgesics
  • Anticonvulsants
  • Clonidine
  • Gabapentin
  • Narcotic antagonists
  • Non-steroidal antiinflammatory drugs
  • Opioid
  • Pain
  • Pregabalin
  • Regional anesthesia techniques

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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