Document Detail

Safety of morphine in nonintubated infants in the neonatal intensive care unit.
MedLine Citation:
PMID:  19454876     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine the safety of morphine for procedural pain management in nonintubated infants in the neonatal intensive care unit. METHODS: Retrospective cohort study comparing nonintubated infants undergoing central line placement who received morphine during the procedure with a sex and age-matched group who did not receive morphine. The incidence of clinically significant respiratory depression and hypotension, defined as requiring intervention (ie, bag/mask ventilation, increased ventilatory support, and naloxone reversal for respiratory depression and saline volume expansion and inotropes for hypotension), were compared between groups using chi test. RESULTS: There were no differences (P>0.05) between morphine (N=43) and no morphine (N=43) groups in gestational age [34.2 (4.6) vs. 34.6 (3.8) wk; P=0.63], postnatal age [13.7 (22.6) vs. 12.3 (15) wk; P=0.73], and weight [2.3 kg (0.9) for both groups]. Five (11.6%) morphine-treated infants experienced respiratory depression compared with none (0%) in the no morphine group (P=0.02); removal of 2 overdosed infants in the morphine group reduced the incidence to 7.3%, which was not significantly different from 0% in the no morphine group (P=0.07). There were no cases of hypotension. CONCLUSIONS: Morphine administration was associated with respiratory depression but not hypotension when administered to nonintubated infants undergoing central line placement. Morphine should be used with caution in this population.
Anna Taddio; Blondel Crosdale; Mary-Ellen Hogan; Manal F El Sayed; Kyong-Soon Lee; Aideen M Moore; Vibhuti Shah
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Clinical journal of pain     Volume:  25     ISSN:  1536-5409     ISO Abbreviation:  Clin J Pain     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-20     Completed Date:  2009-08-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8507389     Medline TA:  Clin J Pain     Country:  United States    
Other Details:
Languages:  eng     Pagination:  418-22     Citation Subset:  IM    
Pharmacy Practice Division, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.
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MeSH Terms
Analgesics, Opioid / therapeutic use
Hypotension / diagnosis,  epidemiology*
Infant, Newborn
Intensive Care Units, Neonatal / statistics & numerical data*
Intubation / statistics & numerical data
Morphine / therapeutic use*
Ontario / epidemiology
Pain / epidemiology*,  prevention & control*
Respiratory Insufficiency / diagnosis,  epidemiology*
Retrospective Studies
Risk Assessment / methods
Risk Factors
Treatment Outcome
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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