Abstract
Endotracheally intubated (EI) children usually require some combination of sedative (i.e., morphine) and paralyzing (i.e., pancuronium) medications. The potential for inducing physiological drug dependency in such children should increase in proportion to both the dosage and duration of sedation. A retrospective review of 13 admissions to a multidisciplinary pediatric ICU who are EI ≥ 9 days revealed a progressive increase in morphine requirement on a stable pancuronium dosage.
Ten children received < 8mg/kg total morphine dosage for the first nine days of EI. Of this group, only one patient developed morphine dependency and only after receiving > 16mg/kg cumulative morphine dosage over several subsequent weeks of EI. The remaining three children received >16mg/kg cumulative morphine dosage and each showed signs of dependency. Our conclusion is that cumulative morphine dosage may help to identify EI children at risk of withdrawal.
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Friedman, B., Mickell, J. & Maurer, H. 177 PREDICTION OF MORPHINE DEPENDENCY IN ENDOTRACHEALLY INTUBATED CHILDREN. Pediatr Res 19, 140 (1985). https://doi.org/10.1203/00006450-198504000-00207
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DOI: https://doi.org/10.1203/00006450-198504000-00207