For children who have had their tonsils or adenoids removed, treating post-operative pain with morphine may prove fatal, according to a new study published in PEDIATRICS.
Years ago, codeine was used as the standard treatment for post-operative pain across the nation, including in children who had undergone a tonsillectomy or adenoidectomy. Then, a study in 2012 discovered codeine could cause potentially fatal respiratory problems, which led many clinicians to prescribe morphine to children who underwent surgery in hopes the drug would be more predictable.
Researchers have analyzed the results of administering morphine for post-operative pain to children and compared the data to the results of children who were given oral ibuprofen. The clinical trial included 91 children.
Although pain was managed effectively in both groups of children, researchers found 68 percent of children who took ibuprofen showed improvement in the number incidents of oxygen concentration dropping in the blood whereas only 14 percent of the children on morphine improved.
Additionally, the condition of many of the children on morphine worsened and one child suffered a life-threatening adverse drug reaction that included oxygen concentration dropping in the blood.
According to corresponding author of the study Gideon Koren, MD, the evidence suggests that neither morphine nor codeine should be given to children for post-operative pain.
"The good news is that we now have evidence that indicates ibuprofen is safe for these kids, and is just as effective in controlling their pain, so there's a good alternative available for clinicians to prescribe," Dr. Koren said.
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