Effect of intra-op morphine on children with OSA undergoing tonsillectomy

Daniel C. O'Brien, Yuti Desai, Jane R. Schubart, Robert T. Swanson, Scott Chung, Uma ramesh Parekh, Michele M. Carr

Research output: Contribution to journalArticle

Abstract

Objectives: 1. To compare outcomes after tonsillectomy for pediatric patients with obstructive sleep apnea (OSA) given morphine intra-operatively and post operatively compared to those who were not – specifically Recovery Room (RR) time, length of stay (LOS), Emergency Department (ER) visits. Study design: Retrospective case series with chart review. Setting: Tertiary care children's hospital. Subjects and methods: All children between 1 and 17 years old who had undergone tonsillectomy in a single institution from 2013 to 2016. Comparison between children who had received morphine intra-operatively was made for outcomes. Results: 556 patients were included, 73 patients had morphine intraoperatively and 483 did not; these latter children were older (8.8 vs 6.5 years, P < 0.001), and had fewer episodes of obstructive apnea and hypopnea (AHI 4.47 vs 10.15, p = 0.003) than children who did not receive intra-op morphine. There were no differences in co-morbidities including asthma, whether they had a sleep study, time in the operating room, emergence time, RR time, airway complications, IMC/PICU admission for respiratory distress, ER visits, readmissions, bleeding or post-discharge nurse phone calls. There was a longer LOS (25.9 vs 21.4 h, P = 0.011) for the group receiving intra-op morphine. Conclusion: Children with OSA who receive intra-op morphine have a longer LOS suggesting that its use should be examined more closely in this population.

Original languageEnglish (US)
Pages (from-to)141-146
Number of pages6
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume125
DOIs
StatePublished - Oct 1 2019

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Tonsillectomy
Obstructive Sleep Apnea
Morphine
Recovery Room
Length of Stay
Hospital Emergency Service
Apnea
Tertiary Healthcare
Operating Rooms
Sleep
Asthma
Retrospective Studies
Nurses
Pediatrics
Hemorrhage
Morbidity
Population

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Otorhinolaryngology

Cite this

O'Brien, Daniel C. ; Desai, Yuti ; Schubart, Jane R. ; Swanson, Robert T. ; Chung, Scott ; Parekh, Uma ramesh ; Carr, Michele M. / Effect of intra-op morphine on children with OSA undergoing tonsillectomy. In: International Journal of Pediatric Otorhinolaryngology. 2019 ; Vol. 125. pp. 141-146.
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abstract = "Objectives: 1. To compare outcomes after tonsillectomy for pediatric patients with obstructive sleep apnea (OSA) given morphine intra-operatively and post operatively compared to those who were not – specifically Recovery Room (RR) time, length of stay (LOS), Emergency Department (ER) visits. Study design: Retrospective case series with chart review. Setting: Tertiary care children's hospital. Subjects and methods: All children between 1 and 17 years old who had undergone tonsillectomy in a single institution from 2013 to 2016. Comparison between children who had received morphine intra-operatively was made for outcomes. Results: 556 patients were included, 73 patients had morphine intraoperatively and 483 did not; these latter children were older (8.8 vs 6.5 years, P < 0.001), and had fewer episodes of obstructive apnea and hypopnea (AHI 4.47 vs 10.15, p = 0.003) than children who did not receive intra-op morphine. There were no differences in co-morbidities including asthma, whether they had a sleep study, time in the operating room, emergence time, RR time, airway complications, IMC/PICU admission for respiratory distress, ER visits, readmissions, bleeding or post-discharge nurse phone calls. There was a longer LOS (25.9 vs 21.4 h, P = 0.011) for the group receiving intra-op morphine. Conclusion: Children with OSA who receive intra-op morphine have a longer LOS suggesting that its use should be examined more closely in this population.",
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Effect of intra-op morphine on children with OSA undergoing tonsillectomy. / O'Brien, Daniel C.; Desai, Yuti; Schubart, Jane R.; Swanson, Robert T.; Chung, Scott; Parekh, Uma ramesh; Carr, Michele M.

In: International Journal of Pediatric Otorhinolaryngology, Vol. 125, 01.10.2019, p. 141-146.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effect of intra-op morphine on children with OSA undergoing tonsillectomy

AU - O'Brien, Daniel C.

AU - Desai, Yuti

AU - Schubart, Jane R.

AU - Swanson, Robert T.

AU - Chung, Scott

AU - Parekh, Uma ramesh

AU - Carr, Michele M.

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N2 - Objectives: 1. To compare outcomes after tonsillectomy for pediatric patients with obstructive sleep apnea (OSA) given morphine intra-operatively and post operatively compared to those who were not – specifically Recovery Room (RR) time, length of stay (LOS), Emergency Department (ER) visits. Study design: Retrospective case series with chart review. Setting: Tertiary care children's hospital. Subjects and methods: All children between 1 and 17 years old who had undergone tonsillectomy in a single institution from 2013 to 2016. Comparison between children who had received morphine intra-operatively was made for outcomes. Results: 556 patients were included, 73 patients had morphine intraoperatively and 483 did not; these latter children were older (8.8 vs 6.5 years, P < 0.001), and had fewer episodes of obstructive apnea and hypopnea (AHI 4.47 vs 10.15, p = 0.003) than children who did not receive intra-op morphine. There were no differences in co-morbidities including asthma, whether they had a sleep study, time in the operating room, emergence time, RR time, airway complications, IMC/PICU admission for respiratory distress, ER visits, readmissions, bleeding or post-discharge nurse phone calls. There was a longer LOS (25.9 vs 21.4 h, P = 0.011) for the group receiving intra-op morphine. Conclusion: Children with OSA who receive intra-op morphine have a longer LOS suggesting that its use should be examined more closely in this population.

AB - Objectives: 1. To compare outcomes after tonsillectomy for pediatric patients with obstructive sleep apnea (OSA) given morphine intra-operatively and post operatively compared to those who were not – specifically Recovery Room (RR) time, length of stay (LOS), Emergency Department (ER) visits. Study design: Retrospective case series with chart review. Setting: Tertiary care children's hospital. Subjects and methods: All children between 1 and 17 years old who had undergone tonsillectomy in a single institution from 2013 to 2016. Comparison between children who had received morphine intra-operatively was made for outcomes. Results: 556 patients were included, 73 patients had morphine intraoperatively and 483 did not; these latter children were older (8.8 vs 6.5 years, P < 0.001), and had fewer episodes of obstructive apnea and hypopnea (AHI 4.47 vs 10.15, p = 0.003) than children who did not receive intra-op morphine. There were no differences in co-morbidities including asthma, whether they had a sleep study, time in the operating room, emergence time, RR time, airway complications, IMC/PICU admission for respiratory distress, ER visits, readmissions, bleeding or post-discharge nurse phone calls. There was a longer LOS (25.9 vs 21.4 h, P = 0.011) for the group receiving intra-op morphine. Conclusion: Children with OSA who receive intra-op morphine have a longer LOS suggesting that its use should be examined more closely in this population.

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