Childhood fractures: Ibuprofen vs. Morphine

ibuprofen vs. morphine

Ibuprofen is a safer alternative than oral morphine for relieving pain in children with broken bones, a study published in the Canadian Medical Association journal said. Both medications are about equally effective pain relievers in children and adults, but the side effects linked to morphine make it unsuitable for the former. “We found no significant difference in analgesic efficacy between orally administered morphine and ibuprofen. However, morphine was associated with a significantly greater number of adverse effects,” the researchers wrote. “Our results suggest that ibuprofen remains safe and effective for outpatient pain management I children with uncomplicated fractures.”

About 10% to 25% of all childhood injuries are fractures characterized by intense pain in the first 48 hours, meaning that choosing wisely from the few analgesics available – codeine being out of the question – is essential. Notwithstanding that, “evidence suggests that orally administered morphine and other opioids are increasingly being prescribed,” Dr. Naveen Poonai of the London Health Sciences Center and Western University, in Ontario said in a statement released on October, 27th. “However, evidence for the oral administration of morphine in acute pain management is limited. Thus, additional studies are needed to address this gap in knowledge and provide a scientific basis for outpatient analgesic choices in children.”

Poonai and colleagues compared the effects of oral morphine and ibuprofen in 134 children between the ages of 5 and 17 in order to establish whether morphine was more effective as a pain reliever in subjects who had fractures that did not require surgery. Though both drugs effectively decreased pain, morphine caused such adverse effects as drowsiness, nausea, and vomiting. “Given that morphine was associated with significantly more adverse effects, we conclude that ibuprofen remains a safe and effective therapy for outpatient management of children's fracture pain,” the researchers summarized. “We hope that our results will provide clinicians with a foundation for rational analgesic choices for children with fractures who are discharged from the emergency department.”