Jordan was a 10-year-old child with no past medical history who sustained polytrauma after an 18-foot fall. Their resultant injuries included abdominal trauma, pelvic fracture, left femur fracture, and left radial fracture. Following their initial exploratory laparotomy, bowel resection with anastomosis, and open reduction and internal fixation of their fractures, they were transferred to the pediatric critical care unit for mechanical ventilatory support and hemodynamic monitoring. Jordan was extubated on postoperative day 1.

Adequate, timely management of pain reduces the numerous adverse physiologic and psychological effects associated with pain. Physiologic effects include cardiovascular (hypertension and increased oxygen demand), respiratory (tachypnea, shallow breathing, and atelectasis), immune (increased susceptibility to infection), endocrine (hyperglycemia and increased cortisol), gastrointestinal (slow gastrointestinal motility), musculoskeletal (guarding and muscle tension), and changes in central nervous system pain processing.1  Poorly controlled pain is also associated with impaired sleep, reduced quality of life, and impaired physical function....

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