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Intrathecal morphine (ITM) for postoperative pain control in children: a comparison with nalbuphine patient

S W Krechel1, M A Helikson, D Kittle

  • 1Department of Anesthesiology, University of Missouri-Columbia School of Medicine 65212, USA.

Paediatric Anaesthesia
|January 1, 1995
PubMed

Insights

Single shot spinal morphine provided superior postoperative pain relief in children compared to patient-controlled nalbuphine. While urinary retention was more common with spinal morphine, overall serious complications were similar, indicating its effectiveness and safety.

Area of Science:

  • Pediatric Anesthesiology
  • Pain Management
  • Pharmacology

Background:

  • Postoperative pain management in children undergoing abdominal or thoracic surgery is critical.
  • Evaluating different analgesic techniques is essential for optimizing patient outcomes.

Purpose of the Study:

  • To compare the efficacy and safety of single-shot spinal morphine (ITM) versus patient-controlled nalbuphine (PCA nalbuphine) for postoperative pain relief in pediatric patients.

Main Methods:

  • Retrospective study of 52 pediatric patients (1984-1993) undergoing abdominal or thoracic procedures.
  • Review of nursing and physician records for pain assessments, complications, respiratory depression, nausea/vomiting, pruritus, and urinary retention.

Main Results:

  • ITM demonstrated significantly better pain relief (2.2 hours in pain) compared to PCA nalbuphine (9.2 hours in pain) in the first 24 hours postoperatively.
  • Urinary retention was significantly more frequent with ITM (58.6%) than PCA nalbuphine (8.7%).
  • No significant differences were observed in other narcotic-related complications, duration of hospital stay, or ICU stay.

Conclusions:

  • Single-shot spinal morphine is a safe and effective technique for managing postoperative pain in children following thoracic or upper abdominal procedures.
  • ITM offers superior pain relief compared to PCA nalbuphine with comparable serious complication rates.

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