• Bethany W Ibach, Carol Loeber, Mohanad Shukry, Tracy M Hagemann, Donald Harrison, and Peter N Johnson.
• Assistant Professor, Department of Pharmacy Practice, Texas Tech University Health Sciences Center School of Pharmacy, Abilene, Texas.
• J Opioid Manag. 2015 Jul 1;11(4):295-303.

ObjectiveIntrathecal (IT) morphine improves pain control and decreases opioid requirements in children following thoracic and abdominal surgery. However, studies in children report variable durations of analgesia following IT morphine. The purpose of this study is to describe the duration of analgesia in children undergoing surgical correction of idiopathic scoliosis.DesignRetrospective chart review.SettingPediatric hospital within a tertiary care academic medical center.ParticipantsForty-four pediatric patients with idiopathic scoliosis who received IT morphine following posterior spinal fusion (PSF).Main Outcome Measure(S)Mean opioid exposure 0-12 hours and 13-24 hours post-IT morphine.ResultsMean opioid exposure was significantly increased during the 13-24-hour compared to the 0-12-hour time period (23.0 ± 12.5 mg parenteral morphine vs 15.9 ± 1.7 mg; p = 0.0006). The only factors significantly associated with morphine exposure during the 0-12-hour period included the median pain score (0-12 hours) (odds ratio [OR], 1.92; 95% confidence interval [CI], 0.033-3.80; p = 0.046) and total acetaminophen dose (OR, 0.003; 95% CI, 0.0008-0.005; p = 0.011).ConclusionsThese data indicate that patients experienced improved analgesia for at least 12 hours following IT morphine. Increased use of adjuvant analgesics such as acetaminophen may reduce opioid requirements following PSF procedures. More studies are needed to investigate the combination of adjuvants and IT morphine to reduce postoperative pain in this population.

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