UMEM Educational Pearls

Category: Pediatrics

Title: Oral morphine versus ibuprofen in postoperative orthopedic pain in children

Keywords: Pain control in children, opiates, NSAIDS, motrin, orthopedic (PubMed Search)

Posted: 1/19/2018 by Jenny Guyther, MD
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This was a randomized superiority trial of 0.5mg/kg of oral morphine every 6 hours to 10 mg/kg of ibuprofen every 6 hours in children 5-17 years old who had minor outpatient orthopedic surgeries.  There were 77 patients in each group.  Primary outcome was pain as rated on the Faces pain scale.  Secondary outcomes were additional analgesic requirements, adverse events, and unplanned visits to the doctor.

Bottom line: Oral morphine was not superior to ibuprofen and both drugs decreased pain with no difference in efficacy.  Morphine was associated with more adverse events.



Poonai et al.  Oral Morphine versus ibuprofen administered at home for postoperative orthopedic pain in children: a randomized controlled trial. CMAJ 2017. 189: E1252-E1258.