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Comparison of morphine sulphate and codeine phosphate in children undergoing adenotonsillectomy

D Semple1, S Russell, E Doyle

  • 1Department of Anaesthesia, Royal Hospital for Sick Children, Edinburgh, UK.

Paediatric Anaesthesia
|April 6, 1999
PubMed

Insights

Codeine phosphate and morphine sulphate offer similar pain relief for children after adenotonsillectomy. However, codeine resulted in less postoperative vomiting compared to morphine.

Area of Science:

  • Pediatric Anesthesiology
  • Pain Management
  • Pharmacology

Background:

  • Postoperative pain management in children is crucial.
  • Adenotonsillectomy is a common pediatric surgical procedure often associated with significant pain.
  • Evaluating equianalgesic doses of different analgesics is essential for optimizing pain control and minimizing side effects.

Purpose of the Study:

  • To compare the efficacy and side effect profiles of intramuscular morphine sulphate and codeine phosphate in children undergoing adenotonsillectomy.
  • To determine equianalgesic doses for postoperative pain management in this pediatric population.

Main Methods:

  • A double-blind study was conducted with 40 healthy children.
  • Participants received either morphine sulphate (0.15 mg.kg-1) or codeine phosphate (1.5 mg.kg-1) intramuscularly.
  • Pain scores, analgesic requirements, and sedation scores were monitored over 24 hours post-procedure.

Main Results:

  • No significant differences were observed in pain scores, analgesic needs, or sedation between the morphine and codeine groups.
  • A significantly higher incidence of vomiting occurred in the morphine group (60%) compared to the codeine group (30%) within the first six hours post-surgery (P < 0.05).

Conclusions:

  • Codeine phosphate provides comparable postoperative analgesia to morphine sulphate for adenotonsillectomy in children.
  • Codeine phosphate is associated with a lower incidence of postoperative vomiting than morphine sulphate in this patient group.

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