Pain is a common problem for children, and pain management comprises both pharmacologic and nonpharmacologic measures. For moderate to severe pain, oral opioids have been a popular choice for the last few decades. Codeine has historically been the best-known oral opioid for use in children. However, availability and use of codeine have sharply declined due to safety concerns. A variety of other opioids have been used in place of codeine, but data are limited regarding their efficacy and safety in children. While the same pathways metabolize oral oxycodone as codeine, oxycodone’s pharmacokinetics varies widely. There are also limited data on the safety and efficacy of oral hydromorphone and tramadol use for children. Oral morphine is the opiate alternative to codeine for which there is the most evidence of safety and efficacy in children. Research is needed to investigate both other opioids and non-opioid approaches to guide evidence-based analgesic therapy and treatment for moderate-to-severe pain in children.

中文翻译：

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后可待因时代使用口服阿片类药物控制儿童疼痛

疼痛是儿童的常见问题，疼痛管理包括药物和非药物措施。对于中度至重度疼痛，口服阿片类药物在过去几十年中一直是一种流行的选择。可待因历来是最知名的儿童口服阿片类药物。然而，由于安全问题，可待因的供应和使用急剧下降。各种其他阿片类药物已被用于代替可待因，但有关其对儿童的疗效和安全性的数据有限。虽然与可待因代谢口服羟考酮的途径相同，但羟考酮的药代动力学差异很大。关于儿童口服氢吗啡酮和曲马多的安全性和有效性的数据也有限。口服吗啡是可待因的阿片类药物替代品，其对儿童的安全性和有效性的证据最多。