Primum non nocere. First, do no harm. This dictum is a hallmark of medical practice. Yet it has been common practice to allow the more vulnerable patients, both children and impaired adults, to experience avoidable harm on a regular basis [1-4]. Harm occurs when the amount of hurt or suffering is greater than necessary to achieve the intended benefit . The undertreatment of children's pain, particularly in the chronic pain syndrome and the non-postoperative procedural setting, is a persistent problem, occurring despite the well-documented safety, efficacy and improved patient out-comes that are related to proper pain management; this continued practice thus constitutes harm [5-7]. The exception to this generality is the postoperative setting. Strides have recently been made in paediatric postoperative pain management, and appropriately potent analgesics are now commonly, though not uniformly, ordered .