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Published on: July 29, 2014

Effects of systemic and epidural morphine on antidiuretic hormone levels in children

Pervin Bozkurt1, Guner Kaya, Yuksel Yeker

  • 1Department of Anaesthesiology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey. apbs@istanbul.edu.tr

Paediatric Anaesthesia
|July 9, 2003
PubMed

Insights

Morphine administration during pediatric surgery, whether epidural or intravenous, did not significantly affect antidiuretic hormone (ADH) secretion, despite effectively managing pain and stress hormone responses.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Endocrinology

Background:

  • Opioids are used in general anesthesia to manage surgical stress and pain.
  • The impact of opioids on antidiuretic hormone (ADH) secretion remains debated.
  • This study investigated the effects of morphine administration via different routes on ADH and stress hormones in children.

Purpose of the Study:

  • To determine the effects of epidural versus intravenous morphine on antidiuretic hormone (ADH) levels.
  • To evaluate the impact of morphine on other stress hormones, including cortisol, glucose, and insulin.
  • To assess pain and stress responses in pediatric surgical patients receiving different morphine regimens.

Main Methods:

  • Fifty pediatric patients (1-15 years) undergoing major abdominal or genitourinary surgery were randomized into two groups.
  • One group received a single dose of epidural morphine, while the other received intravenous morphine infusion.
  • Plasma samples were collected at multiple time points to measure ADH, osmolality, glucose, cortisol, insulin, and morphine levels.

Main Results:

  • Both epidural and intravenous morphine effectively managed pain and suppressed cortisol and insulin responses.
  • Serum morphine levels showed statistically significant changes in the epidural group.
  • While ADH levels changed significantly over time in both groups, they returned to baseline by 24 hours, indicating no sustained effect.

Conclusions:

  • Systemic or epidural morphine administration effectively controls pain and stress responses in pediatric surgery.
  • Morphine administration, regardless of route, does not appear to significantly alter antidiuretic hormone (ADH) secretion.
  • The findings contribute to understanding opioid effects on hormonal balance during pediatric anesthesia.
Abstract

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