Evaluating patterns of morphine use in a neonatal intensive care unit after NEOPAIN.
OBJECTIVE
To test the hypothesis that use of morphine for sedation of ventilated premature neonates has not changed despite evidence-based recommendations.


METHODS
Retrospective chart review.


RESULTS
Of 410 ventilated patients, 129 received a morphine infusion. The annual percentage of ventilated patients started on an infusion did not vary significantly from 2005-2010 (range: 27%-37%, mean: 32%, χ2 test for trend p = 0.60). Patients given morphine infusion had a lower median estimated gestational age at birth (26 0/7 weeks versus 27 6/7 weeks), and a lower median birth weight (762 versus 1010 grams).


CONCLUSIONS
Use of morphine as a sedative and/or pre-emptive analgesic agent for critically ill, ventilated, premature neonates has not decreased at the study site despite evidence-based recommendations against this treatment approach. This is an area of care that may benefit from quality improvement interventions.
Department of Pediatrics, Drexel University College of Medicine, Philadelphia, PA, USA.
R
R
Fleishman
Department of Pediatrics, Drexel University College of Medicine, Philadelphia, PA, USA.
C A
CA
Gleason
Seattle Children's Research Institute, Center for Child Health, Behavior, and Development, Seattle, WA, USA.
M T
MT
Myaing
Seattle Children's Research Institute, Center for Child Health, Behavior, and Development, Seattle, WA, USA.
C
C
Zhou
Department of Pediatrics, Drexel University College of Medicine, Philadelphia, PA, USA Seattle Children's Research Institute, Center for Child Health, Behavior, and Development, Seattle, WA, USA.
R
R
Mangione-Smith
D000701:Analgesics, Opioid / Q000008:administration & dosage*; D001724:Birth Weight; D019317:Evidence-Based Medicine; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007262:Infusions, Intravenous; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D008297:Male; D009020:Morphine / Q000008:administration & dosage*; D012121:Respiration, Artificial / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors
D000701:Analgesics, Opioid; D009020:Morphine
Neonatal pain; opiate; sedation