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Sublingual morphine may be a suitable alternative for pain control in children in the postoperative period
1Department of Anaesthesia and Intensive Care, Aberdeen Royal Hospital Trusts, Foresterhill, Aberdeen, UK.
Insights
Sublingual morphine offers a viable alternative to intravenous morphine for managing pediatric postoperative pain after adenotonsillectomy. This pilot study found no significant differences in pain, sedation, or side effects between the two methods.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Pharmacology
Background:
- Postoperative pain management in children undergoing adenotonsillectomy is crucial.
- Various routes of opioid administration exist, each with potential benefits and drawbacks.
Purpose of the Study:
- To compare the efficacy and safety of sublingual morphine versus intravenous morphine for treating pain after pediatric adenotonsillectomy.
- To evaluate key postoperative recovery parameters including pain, sedation, and adverse events.
Main Methods:
- A pilot study involving 29 children undergoing adenotonsillectomy.
- Random assignment to receive either sublingual morphine (0.1 mg/kg) or intravenous morphine (0.1 mg/kg) followed by rectal diclofenac.
- Assessment of pain scores, sedation levels, time to eye opening, analgesia requests, and incidence of nausea/vomiting.
Main Results:
- No statistically significant differences were observed between the sublingual and intravenous morphine groups in pain scores, sedation, time to eye opening, or need for further analgesia.
- Incidence of nausea and vomiting was also comparable between the two treatment groups.
Conclusions:
- Sublingual morphine demonstrates potential as an effective and safe alternative for pediatric postoperative pain management following adenotonsillectomy.
- Further research is warranted to explore the sublingual route for opioid administration in pediatric populations.
Abstract:
The purpose of this pilot study was to compare the effects of sublingual morphine with intravenous morphine in the treatment of postoperative pain following adenotonsillectomy in children. Twenty-nine children scheduled for adenotonsillectomy were randomly assigned to group 1 (n=14) receiving 0.1 mg x kg(-1) sublingual morphine and group 2 (n=15) 0.1 mg x kg(-1) intravenous morphine followed by 1 mg x kg(-1) diclofenac rectally in both groups after induction of anaesthesia. Postoperatively, time to first eye opening, sedation score, pain score, time for further analgesia requests and incidence of nausea and vomiting were recorded. There was no statistical significant difference in any of these parameters between the two groups. The results suggest that sublingual morphine may be a suitable alternative to various other routes of opioid administration in children, but further investigations of the sublingual route of administration of opioids in children are required.