A median 14% fentanyl dose reduction was noted when transitioning to hydromorphone. Further exploration is needed to determine if opioid rotations with hydromorphone can reduce opioid/sedative exposure.

A total of 36 children were converted to hydromorphone.

The median conversion percentage of hydromorphone was 86% of their fentanyl dose (interquartile range [IQR] = 67-100).

The median hydromorphone rate at stabilization was 0.08 mg/kg/h (IQR = 0.05-0.1).

Eight (22%) were stabilized on their initial hydromorphone rate; 8 (22%) never achieved stabilization.

Patients had a significant decrease in opioid dosing on the day of conversion versus the 24-hour period prior to conversion but no changes in sedative dosing following conversion.

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