Long-term subcutaneous morphine administration after surgery in newborns

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Abstract

Aim

To analyze the management of newborns after major surgery receiving morphine subcutaneously and to identify possible side effects.

Methods

Morphine was administered via a subcutaneous catheter (Insuflon®) in 20 newborns after major surgery. Side effects like hypotension, pain during morphine administration and local infection were noted. Morphine dose was adjusted according to the hospital guidelines with the Neonatal Infant Pain Score (NIPS) and the Finnegan withdrawal score.

Results

Surgery was performed at the median age of 38 5/7 weeks (range: 32 1/7–49 5/7 weeks). Before starting subcutaneous morphine administration, patients received intravenous morphine for a median of two weeks (range six days to seven weeks). All patients showed good pain relief with no severe side effects. Three patients reacted with crying to the first dose of subcutaneous morphine. No other side effects occurred.

Conclusion

Subcutaneous application of morphine with the Insuflon® catheter is an alternative to intravenous treatment of postoperative pain in neonates. In this small group pain relief was good and side effects were harmless.

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