Evaluating patterns of morphine use in a neonatal intensive care unit after NEOPAIN

R. Fleishman*, C. A. Gleason, M. T. Myaing, C. Zhou, R. Mangione-Smith | JNPM 2014;

Abstract. OBJECTIVE: To test the hypothesis that use of morphine for sedation of ventilated premature neonates has not changed despite evidence-based recommendations. STUDY DESIGN: Retrospective chart review. RESULTS: Of 410 ventilated patients, 129 received a morphine infusion. The annual percentage of ventilated patients started on an infusion did not vary significantly from 2005–2010 (range: 27%–37%, mean: 32%, χ2 test for trend p = 0.60). Patients given morphine infusion had a lower median estimated gestational age at birth (26 0/7 weeks versus 27 6/7 weeks), and a lower median birth weight (762 versus 1010 grams). CONCLUSION: Use of morphine as a sedative and/or pre-emptive analgesic agent for critically ill, ventilated, premature neonates has not decreased at the study site despite evidence-based recommendations against this treatment approach. This is an area of care that may benefit from quality improvement interventions.

*Corresponding Author: 

Dr. Rachel Fleishman, Department of Pediatrics, Division of Neonatology, St. Christopher’s Hospital for Children, 3601 A Street, Philadelphia, PA 19134, USA. Tel.: +1 215 27 5202; Fax: +1 215 427 8192; E-mail: rachel.fleishman@drexelmed.edu.