Objectives: To evaluate current status and problems for the management of analgesia and sedation in Japanese PICU by nurses' viewpoint. Method: A questionnaire concerning analgesia and sedation strategies was sent to all 25 PICUs in Japan. Results: Responses were obtained from 17 units. Among them, 41.2% of the facilities use objective evaluation scoring for pain and 23.5% for sedation, while 23.5% of the facilities set the ideal level of pain relief and 41.2% do so for sedation. In addition, 11.8% follow a protocol for pain relief and 5.9% for sedation. In 29.4% of the facilities, nurses control pain and in 17.6%, they control sedation. The commonly used sedatives and analgesics were midazolam, fentanyl and dexmedetomidine. Most of the units recognized withdrawal syndrome, and tried non-pharmacological interventions. Only 29.4 % of nurses were satisfied with the existing pain management practices and 47.1% were satisfied with sedation practices. Conclusion: According to Japanese PICU nurses, the current management strategies for analgesia and sedation are not yet satisfactory.