title: Analgesia
  
  Starting dose
text: |
  Analgesia
  Starting dose
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  bet | 373/654 | Sana | 03.01.2022 | Hajmi | 1,5 Mb. | | #14803 |
  Analgesia
  Starting dose: 0.05–0.2 mg/kg every 3–6 hours.
  Maximum Daily Dose
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  1.3 mg/kg/day.
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  Route
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  Oral or intragastric.
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  Preparation/Dilution
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  Administer undiluted. However, if required, dilute dose with sterile water to obtain the required volume; ensure adequately mixed, administer immediately and discard any unused portion.
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  Administration
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  Oral. Preferably with feeds.
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  Monitoring
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  Analgesia: All patients should have cardiorespiratory monitoring and be carefully observed, particularly if they are breathing spontaneously. Respiratory depression/apnoea can be reversed with naloxone in opioid-naïve patients.
  In infants with NAS secondary to maternal opioid dependency: Observe for signs of respiratory and cardiac depression. Continuous cardiorespiratory monitoring is recommended if oral morphine dose is > 0.8 mg/kg/day or an additional sedative is used. Naloxone is contraindicated in opioid-dependent neonates. Respiratory depression/apnoea should be treated with supportive measures.
  Observe for urinary retention, abdominal distension or delay in passage of stool.
  Monitor Neonatal Abstinence Syndrome scores in opioid-dependent infants. Recommendations:
  Commence treatment for infants with 3 scores averaging ≥ 8 or 2 scores averaging ≥ 12.
  Increase treatment 10–25% if scores persistently ≥ 8
  Reduce treatment by 10–25% of the highest dose every 2–4 days if scores ≤ 4.
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