ArticleClinical pharmacokinetics2016
Pharmacodynamic Analysis of Morphine Time-to-Remedication Events in Infants and Young Children After Congenital Heart Surgery.
Article in Clinical pharmacokinetics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
7 citing papers in PubMed, 12 citations in OpenAlex.
- Article
- Scoping Review of Paediatric Population Pharmacokinetic Models of Morphine.Clinical pharmacokinetics · 2025Article
- Finding the right hazard function for time-to-event modeling: A tutorial and Shiny application.CPT: pharmacometrics & systems pharmacology · 2022Article
- Postoperative breakthrough pain in paediatric cardiac surgery not reduced by increased morphine concentrations.Pediatric research · 2021Article
- Exploring the Relationship Between Morphine Concentration and Oversedation in Children After Cardiac Surgery.Journal of clinical pharmacology · 2020Article
- Article
- Analysis of opioid consumption in clinical trials: a simulation based analysis of power of four approaches.Journal of pharmacokinetics and pharmacodynamics · 2017Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe aim of this study was to characterize the relationship between morphine plasma concentration and repeated time to postoperative remedication events in children undergoing cardiac surgery.
methodsData from our previously published study of morphine pharmacokinetics were utilized in this pharmacodynamic study. A population survival analysis based on hazard functions was undertaken in NONMEM(®).
resultsHazard was best described by a Gompertz function changing in steps over time. Concentration and age were the only predictors of the hazard function. Concentration producing 50 % reduction in hazard was 19.6 (bootstrap 95 % confidence interval 5.90-49.5 ng/ml). The hazard ratio for a 1-year-old child to a 1-month-old child was 1.91 (1.35-2.86). Sensitivity to morphine decreased with age and leveled off after 1-year of life. Morphine sulfate doses >0.1 mg/kg did not noticeably increase tolerable pain durations.
conclusionTime to remedication is a clinically useful endpoint for assessing opioid-induced analgesia. Sensitivity to morphine treatment is age-dependent. Morphine sulfate doses of 0.1-0.2 mg/kg are adequate for the management of postoperative pain in children. Our findings may help avoid unnecessary large morphine doses in children.
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