Management of Acute Pain in Children: Pharmacologic

Methadone Sliding Scale

A technologically simple regimen involving intravenous loading doses (usually 0.1 to 0.2 mg/kg) and small bolus doses of methadone has been shown to be very effective for postoperative analgesia in children.⁴⁵ Pain is assessed by the nursing staff at intervals not exceeding 4 hours (reverse "PRN" method) and methadone is administered via a "sliding scale". If the pain is rated as severe, 0.07 mg/kg is administered; 0.05 mg/kg is given for moderate pain or 0.03 mg/kg if the pain is considered mild. This method is convenient, inexpensive, and permits easy adjustment of dosing to patients' variable requirements.