Addition of morphine to local anesthetic infiltration does not improve analgesia after pediatric dental extractions.
BACKGROUND
Opioid receptors have been noted in the peripheral nerve endings of afferent neurons. Blockade of these receptors with peripherally administered opioids is believed to result in analgesia.


METHODS
In a prospective, randomized, double-blind study, we studied the analgesic effects of adding a subsystemic dose of morphine to local anesthetic infiltration (lidocaine hydrochloride) during pediatric dental extractions. Forty-two subjects, aged 2-7 years of ASA physical status I-II, were randomized to receive submucous infiltration with either morphine 25 microg.kg(-1) in 2% lidocaine hydrochloride with 1 : 1 00 000 epinephrine (morphine group) or 2% lidocaine hydrochloride with 1 : 1 00 000 epinephrine (control group) at the end of surgery.


RESULTS
There was no difference in postoperative analgesic requirements within the first 24 h. In-hospital acetaminophen consumption was 85% in the morphine group compared with 81% in the control group.


CONCLUSIONS
We conclude that there is no benefit of adding a subsystemic analgesic dose of morphine to local anesthetics for analgesia after dental extractions in children.
Bhananker
Sanjay M
SM
Department of Anesthesiology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada. sbhanank@u.washington.edu
Azavedo
Lawrence F
LF
Splinter
William M
WM
D000779:Anesthetics, Local; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004357:Drug Synergism; D005260:Female; D006801:Humans; D008012:Lidocaine; D008297:Male; D009020:Morphine; D010149:Postoperative Pain / Q000188:drug therapy*; D014081:Tooth Extraction
D000779:Anesthetics, Local; D009020:Morphine; D008012:Lidocaine