Trial reportCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2017
Oral morphine versus ibuprofen administered at home for postoperative orthopedic pain in children: a randomized controlled trial.
Trial report in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 27 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Oral Morphine Versus Ibuprofen for Post-operative Pain Management in Children: a Randomized Controlled Study
Nonopioid Versus Opioid Outpatient Pain Management Following Surgical Fixation of Gartland Type III Supracondylar Humerus Fractures in Children: A Prospective, Randomized Study
Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 63 citations in OpenAlex.
- Ibuprofen for acute postoperative pain in children.The Cochrane database of systematic reviews · 2024Pooled it
- Effect of Esketamine on Postoperative Pain in Children Undergoing Plasma Tonsillectomy: A Double-Blind, Randomized Controlled Trial.Drug design, development and therapy · 2026Trial
- Pharmacokinetics of Morphine Sulfate Orodispersible Tablets and Bioequivalence with Immediate-Release Oral Morphine Sulfate Formulations in Healthy Adult Subjects Under Fasting Conditions: Single-Dose Comparative Bioavailability Studies.Clinical drug investigation · 2022Trial
- Trial
- Comparison of Ketorolac at 3 Doses in Children With Acute Pain: Protocol for A Randomized Controlled Trial.JMIR research protocols · 2025Article
- Opioid Administration and Reduction of Pediatric Ileocolic Intussusception.JAMA network open · 2025Article
- The diversity of hypospadias management in North America: a survey of pediatric urologists.World journal of urology · 2023Article
- Outpatient Opioid Dispensing Patterns for SC Medicaid Children 1-36 Months Old.Maternal and child health journal · 2023Article
- Annual Prevalence of Opioid Receipt by South Carolina Medicaid-Enrolled Children and Adolescents: 2000-2020.International journal of environmental research and public health · 2023Article
- Les pratiques exemplaires pour l'évaluation et le traitement de la douleur chez les enfants.Paediatrics & child health · 2022Review
- Best practices in pain assessment and management for children.Paediatrics & child health · 2022Review
- Spica Casting of Pediatric Femur Fractures: The Pain Management Experience at One Institution.Cureus · 2022Article
- Effect of non-steroidal anti-inflammatory drugs on fracture healing in children: A systematic review.World journal of orthopedics · 2022Article
- Association of prescription drug monitoring program laws with bedridden and missed work days.Health services research · 2021Article
- Pain Management in Children: NSAID Use in the Perioperative and Emergency Department Settings.Paediatric drugs · 2021Review
- Trends in Dispensed Opioid Analgesic Prescriptions to Children in South Carolina: 2010-2017.Pediatrics · 2021Article
- An observational cohort study comparing ibuprofen and oxycodone in children with fractures.PloS one · 2021Observational
- Guidelines for Opioid Prescribing in Children and Adolescents After Surgery: An Expert Panel Opinion.JAMA surgery · 2021Review
- Article
- Contextual risk among adolescents receiving opioid prescriptions for acute pain in pediatric ambulatory care settings.Addictive behaviors · 2020Article
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOral morphine for postoperative pain after minor pediatric surgery, while increasingly popular, is not supported by evidence. We evaluated whether oral morphine was superior to ibuprofen for at-home management of children's postoperative pain.
methodsWe conducted a randomized superiority trial comparing oral morphine (0.5 mg/kg) with ibuprofen (10 mg/kg) in children 5 to 17 years of age who had undergone minor outpatient orthopedic surgery (June 2013 to September 2016). Participants took up to 8 doses of the intervention drug every 6 hours as needed for pain at home. The primary outcome was pain, according to the Faces Pain Scale - Revised, for the first dose. Secondary outcomes included additional analgesic requirements, adverse effects, unplanned health care visits and pain scores for doses 2 to 8.
resultsWe analyzed data for 77 participants in each of the morphine and ibuprofen groups. Both interventions decreased pain scores with no difference in efficacy. The median difference in pain score before and after the first dose of medication was 1 (interquartile range 0-1) for both morphine and ibuprofen (
interpretationMorphine was not superior to ibuprofen, and both drugs decreased pain with no apparent difference in efficacy. Morphine was associated with significantly more adverse effects, which suggests that ibuprofen is a better first-line option after minor surgery.
trial registrationClinicalTrials.gov, no. NCT01686802.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.