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Continuous morphine infusion for postoperative pain in children
1Department of Paediatric Surgery, University of Cape Town.
Abstract:
Previous erratic use of intermittent intramuscular and intravenous morphine or pethidine for postoperative analgesia prompted a prospective trial of continuous intravenous morphine delivered by an infusion pump. The rate was adjusted to keep the patient free of pain--as assessed by observation in the infant and enquiry in the older child. Serum morphine levels were monitored for the first 36 hours. The results of a cohort of 20 patients (aged 3 months-12 years) are presented. Thanks to positive parental and nursing staff support, and absence of complications, administration of postoperative analgesia with continuous intravenous morphine infusion is now standard practice in this unit.
Insights
Continuous intravenous morphine infusion offers effective postoperative pain management for children. This method, supported by staff and parents, has become standard practice, ensuring patients remain pain-free with monitored serum levels.
Area of Science:
- Anesthesiology
- Pediatric Pain Management
- Pharmacology
Background:
- Intermittent administration of intramuscular and intravenous morphine or pethidine for postoperative pain relief in children was previously erratic.
- This led to the need for a more consistent and effective analgesia strategy.
Purpose of the Study:
- To evaluate the efficacy and safety of continuous intravenous morphine infusion for postoperative analgesia in pediatric patients.
- To establish a standardized method for pain management in children following surgery.
Main Methods:
- A prospective trial involving 20 pediatric patients (aged 3 months to 12 years) was conducted.
- Continuous intravenous morphine infusion was administered using a pump, with the rate adjusted based on pain assessment (observation in infants, inquiry in older children).
- Serum morphine levels were monitored for the initial 36 hours post-administration.
Main Results:
- Continuous intravenous morphine infusion effectively managed postoperative pain in pediatric patients.
- The administration was supported by positive parental and nursing staff involvement.
- No significant complications were reported during the trial.
Conclusions:
- Continuous intravenous morphine infusion is a safe and effective method for postoperative analgesia in children.
- The positive outcomes and lack of complications have led to its adoption as standard practice in the unit.
- This approach ensures consistent pain relief and improves patient care in the postoperative pediatric setting.