Long-term subcutaneous morphine administration after surgery in newborns.
OBJECTIVE
To analyze the management of newborns after major surgery receiving morphine subcutaneously and to identify possible side effects.


METHODS
Morphine was administered via a subcutaneous catheter (Insuflon) in 20 newborns after major surgery. Side effects like hypotension, pain during morphine administration and local infection were noted. Morphine dose was adjusted according to the hospital guidelines with the Neonatal Infant Pain Score (NIPS) and the Finnegan withdrawal score.


RESULTS
Surgery was performed at the median age of 38 5/7 weeks (range: 32 1/7-49 5/7 weeks). Before starting subcutaneous morphine administration, patients received intravenous morphine for a median of two weeks (range six days to seven weeks). All patients showed good pain relief with no severe side effects. Three patients reacted with crying to the first dose of subcutaneous morphine. No other side effects occurred.


CONCLUSIONS
Subcutaneous application of morphine with the Insuflon catheter is an alternative to intravenous treatment of postoperative pain in neonates. In this small group pain relief was good and side effects were harmless.
Rouss
Kerstin
K
Department of Neonatology and Intensive Care, University Children's Hospital Zurich, Zurich, Switzerland.
Gerber
Andreas
A
Albisetti
Manuela
M
Hug
Maja
M
Bernet
Vera
V
D000701:Analgesics, Opioid / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D007279:Injections, Subcutaneous; D009020:Morphine / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000188:drug therapy*
D000701:Analgesics, Opioid; D009020:Morphine