Morphine pharmacokinetics and pain assessment in premature newborns☆,☆☆,★
Section snippets
METHODS
Ethical approval was obtained from The University of British Columbia and The British Columbia’s Children’s Hospital. Informed consent was obtained from parents or guardians before study entry.
RESULTS
A total of 496 neonates received morphine infusions during the study period, October 9, 1991, through December 4, 1993; 48 individual newborns (33 boys) completed the protocol (Table I).
PCA group PCA at entry (wk) GA at entry (wk) PNA at entry (d) Birth weight (g) Sex (M:F) Sedation (n) Clinical indications Mechanical ventilation during morphine (n) Analgesia for surgery (n) Analgesia (other) (n) 1 (n = 10) 26.8 ± 0.7 26.6 ± 0.7 1.1 ± 0.3 1083 ± 174 8:2 9 0 1 9 2 (n =
DISCUSSION
The study findings provide evidence that morphine provides analgesia in premature neonates and that morphine clearance increases with PCA. Neonates aged 24 to 27 weeks had the lowest clearance, as expected. Authors have suggested that gestational age weakly correlates with morphine clearance.16, 18 Our data suggest that PCA more accurately reflects morphine clearance.
In the absence of urinary excretion data for morphine and its metabolites, we can only speculate that the lower Cl values, and
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Supported by the B.C. Health Research Foundation (grant No. 5-53006).
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Reprint requests: Christy Silvius Scott, PharmD, BCPS, Assistant Professor, School of Pharmacy, Division of Pharmacotherapy, The University of North Carolina, CB No. 7360, Beard Hall, Chapel Hill, NC 27599-7360.
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0022-3476/99/$8.00 + 0 9/21/100099