Ibuprofen a better first-line option for pediatric postoperative orthopedic pain relief than morphine

A study, published in CMAJ, examined whether oral morphine or ibuprofen was superior for at-home management of postoperative pain for children who had undergone orthopedic surgery.

Naveen Poonai, MD, of the London Health Sciences Center, and colleagues conducted a randomized superiority trial comparing oral morphine to ibuprofen. Researchers studied 77 children between 5 and 7 years old, who underwent minor outpatient orthopedic surgery.

Patients took up to eight doses of interventional drugs every six hours for pain at home. Researchers measured for pain on the Faces Pain Scale — Revised.

Here's what they found:

1. Both morphine and ibuprofen decreased pain scores with no difference.

2. The median difference in pain score before and after the first dose was one for both medications.

3. For each following dose, researchers noted no significant differences in effectiveness.

4. Participants taking morphine reported more adverse events; the most common was drowsiness.

Researchers concluded, "Morphine was not superior to ibuprofen, and both drugs decreased pain with no apparent difference in efficacy. Morphine was associated with significantly more adverse effects, which suggests that ibuprofen is a better first-line option after minor surgery."

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