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Article
Oral Morphine Versus Ibuprofen Administered at Home for Postoperative Orthopedic Pain in Children: a Randomized Controlled Trial
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
  • Naveen Poonai, Western University
  • Natasha Datoo, Western University
  • Samina Ali
  • Megan Cashin, Western University
  • Amy L Drendel, Children's Hospital of Wisconsin
  • Rongbo Zhu, Western University
  • Natasha Lepore, Western University
  • Michael Greff, Western University
  • Michael Rieder, Western University
  • Debra Bartley, Western University
Document Type
Article
Publication Date
10-10-2017
URL with Digital Object Identifier
https://doi.org/10.1503/cmaj.170017
Disciplines
Abstract

BACKGROUND: Oral morphine for postoperative pain after minor pediatric surgery, while increasingly popular, is not supported by evidence. We evaluated whether oral morphine was superior to ibuprofen for at-home management of children's postoperative pain.

METHODS: We conducted a randomized superiority trial comparing oral morphine (0.5 mg/kg) with ibuprofen (10 mg/kg) in children 5 to 17 years of age who had undergone minor outpatient orthopedic surgery (June 2013 to September 2016). Participants took up to 8 doses of the intervention drug every 6 hours as needed for pain at home. The primary outcome was pain, according to the Faces Pain Scale - Revised, for the first dose. Secondary outcomes included additional analgesic requirements, adverse effects, unplanned health care visits and pain scores for doses 2 to 8.

RESULTS: We analyzed data for 77 participants in each of the morphine and ibuprofen groups. Both interventions decreased pain scores with no difference in efficacy. The median difference in pain score before and after the first dose of medication was 1 (interquartile range 0-1) for both morphine and ibuprofen (

INTERPRETATION: Morphine was not superior to ibuprofen, and both drugs decreased pain with no apparent difference in efficacy. Morphine was associated with significantly more adverse effects, which suggests that ibuprofen is a better first-line option after minor surgery.

TRIAL REGISTRATION: ClinicalTrials.gov, no. NCT01686802.

Citation Information
Naveen Poonai, Natasha Datoo, Samina Ali, Megan Cashin, et al.. "Oral Morphine Versus Ibuprofen Administered at Home for Postoperative Orthopedic Pain in Children: a Randomized Controlled Trial" CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne Vol. 189 Iss. 40 (2017)
Available at: http://works.bepress.com/michael-rieder/1/