Low-dose caudal morphine for postoperative analgesia in infants and children: a report of 500 cases.
OBJECTIVE
To determine the effectiveness of morphine 0.03 mg/kg or 0.04 mg/kg administered caudally to children for postoperative pain relief.


METHODS
Retrospective chart review.


METHODS
University-affiliated hospital.


METHODS
The charts of 500 children who had undergone various surgical procedures and who were given caudal morphine 0.03 mg/kg or 0.04 mg/kg either prior to the surgical procedure or immediately at the conclusion of the surgical procedure.


RESULTS
Parameters of respiratory rate, oxygen saturation, nausea and vomiting, voiding problems, and pruritus were recorded for each patient. There was no respiratory depression noted in the review of the 500 patients; 23% had nausea and vomiting, 3% had voiding problems needing bladder catheterization, and 7% reported pruritus, which was treated with either diphenhydramine or naloxone.


CONCLUSIONS
Statistically there were no differences between morphine 0.03 mg/kg and morphine 0.04 mg/kg in all the study parameters. There was no respiratory depression in the 500 cases reviewed. The postoperative pain relief ranged from 6 hours to over 24 hours. This method of immediate postoperative pain management proved to be effective and safe.
Mayhew
J F
JF
Department of Anesthesiology, Eastern Virginia Medical School, Norfolk, USA.
Brodsky
R C
RC
Blakey
D
D
Petersen
W
W
D000293:Adolescent; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D010149:Postoperative Pain / Q000188:drug therapy*; D012129:Respiratory Function Tests; D012189:Retrospective Studies
D000701:Analgesics, Opioid; D009020:Morphine