title: Preliminary evidence for the effects of morphine on posttraumatic stress disorder symptoms in one- to four-year-olds with burns.
abstract: This study tested the hypothesis that very young children who received more morphine for acute burns would have larger decreases in posttraumatic symptoms 3 to 6 months later. This has never before been studied in very young children, despite the high frequency of burns and trauma in this age group. Seventy 12- to 48-month-old nonvented children with acute burns admitted to a major pediatric burn center and their parents participated. Parents were interviewed at three time points: during their child's hospitalization, 1 month, and 3 to 6 months after discharge. Measures included the Child Stress Disorders Checklist - Burn Version (CSDC-B). Chart reviews were conducted to obtain children's morphine dosages during hospitalization. Mean equivalency dosages of morphine (mg/kg/d) were calculated to combine oral and intravenous administrations. Eleven participants had complete 3 to 6-month data on the CSDC. The correlation between average morphine dose and amount of decrease in posttraumatic stress disorder symptoms on the CSDC (r = -0.32) was similar to that found in studies with older children. The correlation between morphine dose and amount of decrease in symptoms on the arousal cluster of the CSDC was significant (r = -0.63, P < .05). Findings from the current study suggest that, for young children, management of pain with higher doses of morphine may be associated with a decreasing number of posttraumatic stress disorder symptoms, especially those of arousal, in the months after major trauma. This extends, with very young children, the previous findings with 6- to 16-year olds.
authors.affiliation: Shriners Hospitals for Children and Harvard Medical School at Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
authors.forename: Frederick J
authors.initials: FJ
authors.lastname: Stoddard
authors.forename: Erica A
authors.initials: EA
authors.lastname: Sorrentino
authors.forename: T Atilla
authors.initials: TA
authors.lastname: Ceranoglu
authors.forename: Glenn
authors.initials: G
authors.lastname: Saxe
authors.forename: J Michael
authors.initials: JM
authors.lastname: Murphy
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Drake
authors.forename: Heidi
authors.initials: H
authors.lastname: Ronfeldt
authors.forename: Gwyne W
authors.initials: GW
authors.lastname: White
authors.forename: Jerome
authors.initials: J
authors.lastname: Kagan
authors.forename: Nancy
authors.initials: N
authors.lastname: Snidman
authors.forename: Robert L
authors.initials: RL
authors.lastname: Sheridan
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Tompkins
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D000704:Analysis of Variance; D002056:Burns / Q000188:drug therapy* / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008297:Male; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy* / Q000523:psychology*; D010147:Pain Measurement; D010290:Parents / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000517:prevention & control* / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine