The use of postoperative intravenous patient-controlled analgesia with low dose versus standard dose Morphine in children undergoing pelvic-abdominal exploration surgery

Background: Patient-controlled analgesia is an effective method used to alleviate pain in children. Morphine is the standard opium-based analgesic used; however, its use is usually associated with adverse effects that may be severe. This study was carried out to evaluate the efficacy and safety of low-dose Morphine in controlling acute pain in children undergoing exploration surgery. Methods: This study was conducted at Beni-Suef University Hospital on 46 patients. The patients were divided randomly into two equal groups: The standard dose morphine group: Which received 0.05 mg morphine /kg/dose, and the low dose morphine group: Which received 0.01 mg morphine /kg/dose. During post-operative follow-up, the pain was assessed using VAS and VRS in addition to POSS sedation score and follow-up of adverse events. Results: There was no significant difference between the groups' mean VAS and VRS pain scores and their categories. However, the side effects of Morphine, like PONV and respiratory depression, were significantly decreased in the low-dose morphine group. Conclusions: The present study shows that both the low dose and the standard dose of Morphine could effectively control the post-operative pain in patients-controlled analgesia of children undergoing pelvic-abdominal exploration surgeries with a lower incidence of postoperative complications in the low-dose morphine group.