For a Child's Fracture, Use Ibuprofen, Not Morphine: Study

Fewer side effects reported with the over-the-counter pain reliever

By Mary Elizabeth Dallas

Monday, October 27, 2014

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MONDAY, Oct. 27, 2014 (HealthDay News) -- For children with broken bones, ibuprofen is a better choice for pain relief than morphine, researchers report.

Although both medications are effective in easing the pain associated with these injuries, oral morphine carries more risk for negative side effects, Canadian researchers found.

"Evidence suggests that orally administered morphine and other [narcotic painkillers] are increasingly being prescribed," the researchers wrote. "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."

Broken bones account for up to one-quarter of all injuries involving children, the researchers said. The first two days after this type of injury are the most painful. Children have limited choices for pain relief, however, due to safety concerns about their use of codeine.

The study, led by Dr. Naveen Poonai, of London Health Sciences Center in Ontario, involved 134 children, aged 5 to 17, who suffered broken bones but did not require surgery.

The children were randomly selected to receive either morphine or ibuprofen (brand names include Advil or Motrin) to help ease their discomfort. Both medications eased pain. But the kids who took morphine experienced more side effects, including drowsiness, nausea and vomiting, the study published in the Oct. 27 issue of the CMAJ showed.

"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 study authors wrote.

"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," they added.

SOURCE: CMAJ (Canadian Medical Association Journal), news release, Oct. 27, 2014

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