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Relationship between acute morphine and the course of PTSD in children with burns
G Saxe1, F Stoddard, D Courtney
1Department of Child and Adolescent Psychiatry, Boston Medical Center Boston University School of Medicine, MA 02118, USA.
Insights
Higher doses of morphine during acute burn hospitalization may reduce posttraumatic stress disorder (PTSD) symptoms in children. This suggests morphine could potentially prevent PTSD development after traumatic injury.
Area of Science:
- Pediatric Burn Care
- Trauma Psychology
- Pain Management
Background:
- Acute burns are traumatic events in children.
- Posttraumatic stress disorder (PTSD) is a common outcome following traumatic experiences.
- Effective interventions to mitigate PTSD risk in pediatric burn patients are crucial.
Purpose of the Study:
- To examine the association between morphine dosage during acute burn hospitalization and subsequent PTSD symptom trajectories.
- To determine if morphine administration influences the development or severity of PTSD in pediatric burn survivors.
Main Methods:
- A cohort of 24 children hospitalized for acute burns was studied.
- PTSD symptoms were assessed using the Child PTSD Reaction Index at hospitalization and 6 months post-discharge.
- Morphine dosage (mg/kg/day) was calculated from medical records.
Main Results:
- A significant correlation was found between higher morphine doses and a greater reduction in PTSD symptoms over 6 months.
- Children who received higher doses of morphine exhibited a more favorable PTSD symptom course post-discharge.
- Pain levels were also monitored during hospitalization using the Colored Analogue Pain Scale.
Conclusions:
- Acute morphine treatment may offer secondary prevention for PTSD in pediatric burn patients.
- Morphine's potential preventive effect on PTSD could be linked to its influence on fear conditioning and traumatic memory consolidation.
- Further research is warranted to explore the neurobiological mechanisms underlying this association.
Objective:
To investigate the relationship between the dose of morphine administered during a child's hospitalization for an acute burn and the course of posttraumatic stress disorder (PTSD) symptoms over the 6-month period following discharge from the hospital.
Method:
Twenty-four children admitted to the hospital for an acute burn were assessed twice with the Child PTSD Reaction Index: while in the hospital and 6 months after discharge. The Colored Analogue Pain Scale was also administered during the hospitalization. All patients received morphine while in the hospital. The mean dose of morphine (mg/kg/day) was calculated for each subject through chart review.
Results:
The Pearson product moment correlation revealed a significant association between the dose of morphine received while in the hospital and a 6-month reduction in PTSD symptoms. Children receiving higher doses of morphine had a greater reduction in PTSD symptoms over 6 months.
Conclusions:
This study suggests the possibility that acute treatment with morphine can secondarily prevent PTSD. This result is discussed in terms of the possible effect of morphine on fear conditioning and the consolidation of traumatic memory.