LOW-DOSE CAUDAL MORPHINE FOR POSTOPERATIVE ANALGESIA IN INFANTS AND CHILDREN - A REPORT OF 500 CASES

Study Objective: To determine the effectiveness of morphine 0.03 mg/kg or 0.04 mg/kg administered caudally to children for postoperative pai n relief. Design: Retrospective chart review. Setting: University-affi liated hospital. Patients: The charts of 500 children who had undergon e various surgical procedures and who were given caudal morphine 0.03 mg/kg or 0.04 mg/kg either prior to the surgical procedure or immediat ely at the conclusion of the surgical procedure. Measurements and Main Results: Parameters of respiratory rate, oxygen saturation, nausea an d vomiting voiding problems, and pruritus were recorded for each patie nt. There was no respiratory depression noted in the review of the 500 patients, 23% had nausea and vomiting, 3% had voiding problems needin g bladder catheterization, and 7% reported pruritus, which was treated with either diphenhydramine or naloxone. Conclusion: Statistically th ere were no differences between morphine 0.03 mg/kg and morphine 0.04 mg/kg in all the study parameters, There was no respiratory depression in the 500 cases reviewed. The postoperative pain relief ranged from 6 hours to over 24 hours. This method of immediate postoperative pain management proved to be effective and safe.