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Published on: July 29, 2014

Effect of morphine in needle procedures in children with cancer

Lena E Hedén1, Louise von Essen, Gustaf Ljungman

  • 1Department of Women's and Children's Health, Pediatric Oncology, Uppsala University, Sweden. lena.heden@kbh.uu.se

European Journal of Pain (London, England)
|June 18, 2011
PubMed

Insights

Oral morphine did not reduce fear, distress, or pain in children undergoing needle insertion for a subcutaneous port when combined with topical anesthesia. The study found no significant difference compared to placebo, suggesting it offers no additional benefit.

Area of Science:

  • Pediatric oncology
  • Pain management
  • Anesthesiology

Background:

  • Subcutaneous implanted intravenous ports are common in pediatric oncology.
  • Needle insertion into these ports can cause fear, distress, and pain.
  • Topical anesthesia is often used to mitigate procedural discomfort.

Purpose of the Study:

  • To evaluate the efficacy of oral morphine compared to placebo in reducing fear, distress, and pain.
  • To assess the effect of oral morphine when combined with topical anesthesia during port access in children.
  • To determine if a specific dosage of oral morphine (0.25 mg/kg) provides added benefit.

Main Methods:

  • A randomized, triple-blind, placebo-controlled study was conducted.
  • Fifty pediatric patients (1-18 years) received either oral morphine (0.25 mg/kg) or placebo before needle insertion.
  • Fear, distress, and pain were assessed using Visual Analogue Scales (VAS) by parents, nurses, and children (≥7 years), supplemented by observational methods.

Main Results:

  • No significant differences were observed between the morphine and placebo groups in demographic or clinical characteristics.
  • Parents, nurses, and children reported no reduction in fear, distress, or pain with oral morphine compared to placebo.
  • Statistical analysis could not reject the null hypothesis for an effect size of 15 mm on VAS.

Conclusions:

  • Oral morphine at 0.25 mg/kg does not provide additional reduction in fear, distress, or pain compared to placebo when used with topical anesthesia for subcutaneous port needle insertion.
  • The findings suggest oral morphine may not be advantageous for this procedure or similar ones like venipuncture and venous cannulation when topical anesthesia is employed.
  • Further research may be needed to explore alternative or adjunct pain management strategies.
Abstract

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