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Child health
Randomised controlled trial
Morphine is not superior to ibuprofen for managing children’s pain following minor orthopedic surgery
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  1. Cornelius Botha Groenewald
  1. Department of Anesthesiology and Pain Medicine, University of Washington, Seattle Children’s Hospital, Seattle, Washington, USA
  1. Correspondence to Dr Cornelius Botha Groenewald, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle Children’s Hospital, Seattle, WA 98105, USA; cornelius.groenewald{at}seattlechildrens.org

https://doi.org/10.1136/eb-2017-102855

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    Commentary on: Poonai N, Datoo N, Ali S, et al. Oral morphine versus ibuprofen administered at home for postoperative orthopaedic pain in children: a randomised controlled trial. CMAJ 2017;189:E1252–8.

    Implications for practice and research

    • Nurses should encourage parents to use ibuprofen along with paracetamol as the first-line treatment for their children’s postoperative pain at home.

    • Future research is needed to determine the added benefit versus risk of using morphine alongside ibuprofen for postoperative pain control.

    Context

    Morphine and other opioids such as oxycodone and hydrocodone increasingly serve as the cornerstone of children’s postoperative pain treatment. Yet, opioid use may result in a number of complications, including respiratory depression, nausea, constipation and an increased risk for opioid misuse later in life. Given the associated risks, it is important that evidence support the use of opioids over other reliable analgesics such as ibuprofen and paracetamol. …

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