The effect of hydromorphone for postoperative analgesia in children

Despite commonly used in postoperative analgesia, there are limited and inconclusive data for the comparison between morphine and hydromorphone in pediatric population. In this study, we evaluated the efficacy of morphine and hydromorphone intravenously for postoperative analgesia in children. Sixty patients were enrolled and randomly received bolus morphine (group M, 50 mu g/kg), or hydromorphone (group H, 7 mu g/kg) for postoperative analgesia (30 cases per group). VAS at rest and with cough was assessed at the post-operative 1, 2, 3, 6 and 24 h. The frequency use of morphine or hydromorphone and cumulative dose of other opioid, e.g. fentanyl use and their related side effects were recorded for 48 h postoperatively. The satisfaction of analgesia given by young patients or their parents was analyzed. Compared with the group M, the onset time of VAS < 4 cm was shorter (P < 0.05), and the frequency of study drug use in PACU was less (P < 0.05) in the group H; the resting VAS scores at 1, 2, 3, 6, 24 h after bolus injection were no significant differences between two groups, while the coughing VAS scores at 2, 3, 6 h after bolus injection were lower in the group H. Eight patients in group M and two patients in group H need extra fentanyl to relieve pain (P < 0.05) during PACU stay. There were no significant differences in adverse events and satisfaction score of analgesia between two groups. Our results demonstrate that hydromorphone can be effectively used for postoperative pain relief in young patients.