In children who have undergone tonsillectomy, it has not been clear which analgesic is best to use. Codeine has recently been contraindicated for pain management after surgery; remaining options include morphine and ibuprofen.
Now, results of a randomised trial
involving 91 children undergoing tonsillectomy for breathing problems at night have highlighted safety concerns with morphine. On the first night after surgery, just 14% of children given morphine showed an improvement in blood oxygen levels, compared with 32% of those given ibuprofen. Furthermore, apnea events were significantly more frequent with morphine than ibuprofen — a difference of 11 events per hour, on average.
“The evidence clearly suggests that children with obstructive sleep apnoea should not be given morphine for post-operative pain,” says lead study author Gideon Koren of the Hospital for Sick Children in Toronto, Canada.