Paracetamol as effective as morphine after surgery

Paracetamol as effective as morphine after surgery

An intravenous paracetamol drip is a good alternative to morphine after major surgery in young children. Pain after the operation can be alleviated as effectively and paracetamol has fewer side effects. This is one of the conclusions made by physician researcher Ilse Ceelie of Erasmus MC-Sophia’s Pediatric surgery department in her thesis. Ceelie will receive her PhD on 30 September.

Worldwide thousands of children are routinely given morphine to relieve pain after surgery despite the fact that morphine, particularly among the very young (younger than one), can have many side effects including impaired breathing, low blood pressure, intestinal obstruction and seizures. Moreover, little is known about the long-term effects of morphine.

Ceelie is investigating whether paracetamol can be adequately used as an analgesic after surgery. Paracetamol does not have the same serious side effects as morphine. Adult patients who are given an intravenous paracetamol drip appear to need less morphine for adequate pain relief, prompting Ceelie to investigate its use in young children.

Half of the children were given only intravenous paracetamol as pain relief after surgery and the other half (the control group) were first given morphine for analgesia. Any pain was closely monitored with the aid of age-specific pain scales. If pain was suspected, morphine was administered in both the morphine and the paracetamol groups.

Children in the paracetamol group experienced the same amount of pain as the children in the morphine group. The total amount of extra morphine administered was the same for both groups. The total amount of morphine, therefore, given to the children in the paracetamol group was much less than that given to the children in the morphine group.

Ceelie: “Globally, this is an important step forward, particularly in situations where intensive care monitoring after surgery is not always available.”

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