Document Detail


Morphine analgesia as an alternative to general anaesthesia during laser treatment of retinopathy of prematurity.
MedLine Citation:
PMID:  17324215     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine the feasibility and efficacy of morphine sedation/analgesia in the laser treatment of retinopathy of prematurity (ROP). METHODS: A retrospective study was carried out on all infants who underwent laser treatment for ROP over a 7 year period. Morphine infusion commenced 6 hrs prior to treatment at a rate of 10 microg/kg/hr. This rate increased to 20 microg/kg/hr at the start of laser treatment. Subsequent infusion rate was titrated according to tolerance of the laser and cardio and respiratory system changes and evidence of infant distress (truncal and limb movements) up to a maximum rate of 40 microg/kg/hr. Following treatment, morphine was weaned over 6 hrs. Infant ventilation status was recorded prior to and during morphine infusion and during laser treatment. The incidences of adverse cardiac or respiratory events occurring during laser treatment were determined. RESULTS: One hundred and nine infants treated from 1998 to 2005 were involved in the study. One hundred and thirty-six treatments were performed and mean gestational age at the time of treatment was 36 weeks. In 130 treatments, respiratory status remained stable and was not adversely affected. Infants were mechanically ventilated because of morphine-induced apnoea during three treatments, because of poor laser tolerance during two treatments and because of post-procedure apnoea in one case. In 65 treatments, minor alterations in oxygen saturation (< 90%), bradycardia or tachycardia occurred. CONCLUSION: This study demonstrates that morphine analgesia can be used as an alternative to general anaesthesia.
Authors:
Caitriona Kirwan; Michael O'Keefe; Michael Prendergast; Ann Twomey; John Murphy
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2007-02-27
Journal Detail:
Title:  Acta ophthalmologica Scandinavica     Volume:  85     ISSN:  1395-3907     ISO Abbreviation:  Acta Ophthalmol Scand     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-27     Completed Date:  2007-10-23     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9507578     Medline TA:  Acta Ophthalmol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  644-7     Citation Subset:  IM    
Affiliation:
National Maternity Hospital, and Children's University Hospital, Dublin, Ireland.
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MeSH Terms
Descriptor/Qualifier:
Analgesia / methods*
Analgesics, Opioid / administration & dosage*
Anesthesia, General
Birth Weight
Feasibility Studies
Female
Gestational Age
Heart Rate
Humans
Infant, Newborn
Infusions, Intravenous
Laser Coagulation*
Male
Morphine / administration & dosage*
Respiratory Physiological Phenomena
Retinopathy of Prematurity / surgery*
Retrospective Studies
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 57-27-2/Morphine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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