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Department of Anesthesiology; The University of Mississippi Medical Center; Jackson, Mississippi; JMayhew{at}anesthesia.umsmed.edu
To the Editor:
A recent paper by Vetter et al. (1) comparing the effects of a single dose of caudally administered morphine, clonidine, or hydromorphone, each in combination with ropivacaine, in children after ureteral implant surgery found similar pain scores but a lesser incidence of side effects with clonidine. They state in their discussion that a smaller dose of caudal morphine may result in fewer side effects and, referencing my study (wherein 30–40 µg/kg of morphine was used) (2), state that such studies included less painful surgery. However, my study did show that we had fewer side effects but similar duration of painless times as occurred in studies with larger doses of epidural morphine. A more recent study demonstrated similar painless hours as our study but with even smaller doses of morphine (10–20 µg/kg) (3,4). It would appear that equivalent pain relief using less morphine may be achieved with fewer side effects than those seen by the authors in their current study.
Footnotes
Dr. Vetter does not wish to respond.
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