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Clin J Pain. 2009 Jun;25(5):418-22. doi: 10.1097/AJP.0b013e31819b7a3b.

Safety of morphine in nonintubated infants in the neonatal intensive care unit.

Author information

1
Pharmacy Practice Division, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada. anna.taddio@utoronto.ca

Abstract

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.

PMID:
19454876
DOI:
10.1097/AJP.0b013e31819b7a3b
[Indexed for MEDLINE]

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