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Paediatric postoperative pain — FRCA Final MCQ

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EasyPaediatricPaediatric postoperative painFRCA Final

A 6-year-old is crying in recovery after laparoscopic appendicectomy. He received paracetamol, ibuprofen and fentanyl intra-operatively. Pain score is 8/10, respiratory rate is 24/min, oxygen saturation is 98%, and he is haemodynamically stable. What is the most appropriate pain management?

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Correct answer: A — Give titrated intravenous morphine boluses with monitoring

Severe postoperative pain despite simple analgesia and intra-operative fentanyl should be treated with titrated intravenous opioid boluses in a monitored recovery setting. Codeine is unpredictable in children and is not preferred. Intramuscular injections are painful and less titratable. Effective analgesia should be reassessed frequently and integrated with antiemetic and respiratory monitoring.

Reference: APAGBI good practice in postoperative and procedural pain; RCoA GPAS paediatric anaesthesia