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THE EFFICACY OF POST-OPERATIVE PAEDIATRIC INTRAVENOUS NURSE CONTROLLED MORPHINE ANALGESIA: AN AUDIT OF PATIENTS UNDERGOING SPINAL SURGERY

Objective: To evaluate a new system of prescribing and administering IV morphine introduced by our Paediatric Pain Service for paediatric patients undergoing corrective spinal surgery. Design: An audit of post-operative pain management was conducted retrospectively on patients who had undergone scoliosis correction between November 1999 and September 2001. Subjects: Sixteen patients between the ages of nine and seventeen years who had undergone spinal scoliosis correction during the study period were evaluated. Outcome measures : The average post-operative IV morphine consumption, the pain and sedation scores, the incidence of side effects, and the use of adjuvant analgesics were analysed. Statistical evaluation was carried out using the Student’s T test and the Mann-Whitney U test. Results : Morphine consumption was significantly higher in the first post-operative twenty-four hour period, as well as in the over 13 year-old age group. There was no significant difference in morphine consumption between genders or ASA physical status. The pain scores were significantly higher in males compared to females on day one post-operatively. There was no statistical difference in sedation scores. Conclusions : An audit of the post-operative pain regimen for patients undergoing spinal scoliosis correction provided by the Paediatric Pain Management Service has shown that it is both efficient and safe. We recommend an anticipated pain management pathway of recovery following spinal fusion for idiopathic adolescent scoliosis.