A two month old infant has undergone a major surgical procedure. Regarding postoperative pain relief which one of the following is recommended:
D. i.e. Intravenous narcotic infusion in lower dosage Though neonates have immature brain, they neveheless feel painQ and analgesia is needed. During circumcision of babies, standard techniques of G.A. are suitable. They are given a normal intravenous or inhalational induction and spontaneous respiration is maintained using 02 N20 & volatile agent. Morphine is the drug of choice for children who are inpatients. The preferred route of injection is intravenousQ but other routes can be used. Intrathecal route is not the first choice. Following minor surgical procedures, oral acetaminophen (paracetamol), codeine phosphate and ibuprofen may be givn either alone or in combination. After more major surgery continuous infusion of a potent opioid analgesic such as morphine may be requiredQ. Regional nerve blocks & direct local infiltration of surgical wounds with long acting local anesthetics are simple yet very effective methods of providing pain relief for all children. Supplementing the analgesia of ether opioid or regional technique with 40 mg/kg acetaminophen rectally at the beginning of procedure is also recommended (generally in children still in diapers).
No mediaction is needed as infant does not feel pain after surgery due to immaturity of nervous system
Only paracetamol suppository is adequate
Spinal narcotics intrathecal route
Intravenous narcotic infusion in lower dosage