COMPARISON OF MORPHINE REQUIREMENTS FOR SEDATION IN DOWNS-SYNDROME AND NON-DOWNS PATIENTS FOLLOWING PEDIATRIC CARDIAC-SURGERY

Anaesthetists recognize that children with Down's syndrome require spe cial management in a number of clinical situations. There is a widespr ead clinical impression that it is difficult to achieve adequate sedat ion and that, following cardiac surgery, these children require higher doses of morphine and additional sedative agents compared to patients without Down's syndrome. We conducted a retrospective chart review of 16 Down's syndrome and 16 matched non-Down's syndrome children who un derwent cardiac surgery between 1984 and 1991. The average dose of mor phine (continuous infusion) administered per hour was higher in the Do wn's syndrome group than in the non-Down's syndrome group. The differe nce was not statistically or clinically significant until the third po stoperative day. Down's syndrome patients were more likely to still be receiving morphine on Day 3 than non-Down's patients (P<0.05). The Do wn's syndrome patients were also more likely to receive additional sed atives and skeletal muscle relaxants.