Morphine analgesia shows efficacy in ROP laser treatment

Morphine analgesia can be used as an alternative to general anesthesia during laser treatment of infants with retinopathy of prematurity, according to a retrospective study by researchers in Ireland.

Caitriona Kirwan, MD, and colleagues investigated the efficacy of morphine analgesia used during 136 laser treatments performed in 109 infants with ROP at a mean gestational age of 36 weeks.

Morphine infusions at a rate of 10 µg/kg/hr were initiated 6 hours before treatment and were increased to 20 µg/kg/hr once treatment began. After starting treatment, subsequent infusion rates were titrated according to infants' laser tolerance, cardio and respiratory system changes, and evidence of distress. The maximum infusion rate was 40 µg/kg/hr, according to the study.

Postoperatively, patients were weaned off of morphine over 6 hours.

Infants' respiratory statuses remained stable during 130 treatments. However, during six treatments, infants required mechanical ventilation due to morphine-induced apnea, poor laser tolerance or post-procedure apnea, the authors reported.

Minor alterations in oxygen saturation, bradycardia or tachycardia occurred in 65 treatments, they added.

The study is published in the September issue of Acta Ophthalmologica Scandinavica.