Opioids represent one of the time-honored tools for pediatric anesthesiologists in treating the most significant pain and suffering that confront our patients. While we continue to seek adequate pain treatment and avoid the consequences of inadequately treated pain, the reality of the ongoing epidemic of opioid abuse and addiction is a significant issue that demands our attention. At the same time, pediatric anesthesiologists must deal with the complexity (and vulnerability) of the population we treat, including infants who face dependence because of maternal opioid abuse or ICU sedation requirements, children with chronic pain conditions and adolescents who find access to medications in the family medicine cabinet. In response to the evolving issues related to opioid treatment in children, the Society for Pediatric Anesthesia (SPA) and the Society for Pediatric Pain Medicine (SPPM) have engaged a group of experts to formulate evidence-based guidelines for opioid use in the perioperative time period....

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