Preemies Show Little Benefit From Routine Morphine Treatment For Pain

Preterm babies who are admitted to the neonatal intensive care unit (NICU) may need to undergo a variety of procedures that cause pain and discomfort. Many preemie newborns receive morphine, a pain reliever used for all ages, but some medical professionals have questioned whether morphine effectively relieves pain in newborns.

Researchers from The Netherlands examined morphine's effectiveness in relieving pain in a group of 150 newborns who needed ventilator support to help them breathe. The infants were assigned to receive a continuous dose of morphine or a placebo (an inactive solution that contained no morphine) for 7 days. After each dose of morphine or placebo was administered, infants were videotaped for 2 minutes. Infants were also evaluated when they underwent uncomfortable procedures such as airway suctioning. Later, researchers viewed the tapes and scored each infant's reactions.

Morphine did not relieve pain or discomfort more effectively than the placebo, according to scales used to assess infant pain levels. Morphine also had no apparent other effects on the function of the infants' nervous systems.

What This Means to You: The researchers who conducted this study concluded that there aren't enough measurable benefits to warrant routine use of morphine for pain relief in preterm infants. Your preemie's neonatologist or neurologist can help you sort through the issues associated with the use of pain relievers in preterm babies.

Source: Sinno H. P. Simons, MSc; Monique van Dijk, PhD; Richard A. van Lingen, MD, PhD; Daniella Roofthooft, MD; Hugo J. Duivenvoorden, PhD; Niesje Jongeneel, RN; Carin Bunkers, RN; Enna Smink, RN; K. J. S. Anand, MBBS, DPhil; John N. van den Anker, MD, PhD; Dick Tibboel, MD, PhD; Journal of the American Medical Association, November 12, 2003

Reviewed by: Steven Dowshen, MD
Date reviewed: December 2003

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