Skip Navigation LinksHome > May 2008 - Volume 25 - Issue 5 > Age‐adapted morphine titration produces equivalent analgesia...
European Journal of Anaesthesiology:
doi: 10.1017/S0265021507003080
Original Article

Age‐adapted morphine titration produces equivalent analgesia and adverse effects in younger and older patients

Keïta, H.*; Tubach, F.; Maalouli, J.; Desmonts, J.‐M.; Mantz, J.*

Collapse Box


Background: To determine the efficacy and safety of intravenous postoperative morphine titration in the elderly compared with younger patients.

Methods: In the post‐anaesthesia care unit, patients complaining of pain received morphine until adequate pain relief. Intravenous morphine was titrated as 3 mg boluses in young (age ≤65 yr) and 2 mg in elderly patients (>65 yr) every 5 min.

Results: We studied 350 young and 68 elderly patients. There were no significant differences between the two age groups for pain intensity at the onset of titration (numerical rating scale, 7.4 ± 1.7 in young vs. 7.5 ± 1.7 in elderly patients), area under the curve of numerical rating scale vs. morphine boluses (97.7 ± 59.6 vs. 98.2 ± 62), number of boluses required to obtain pain relief (3 ± 1.3 vs. 3 ± 1.3), percentage of titration failures (10% vs. 9%) and incidence of excessive sedation (18% vs. 21%). Renal clearance was significantly reduced in elderly compared with young patients (55 ± 21 vs. 85 ± 15 mL min−1; P < 0.0001).

Conclusion: Using lower bolus doses, pain relief in the immediate postoperative period with morphine was as efficacious and safe in elderly patients as in younger patients. The decrease in renal clearance of morphine in the elderly justifies the reduction of intravenous morphine boluses for the treatment of postoperative pain.

© 2008 European Society of Anaesthesiology


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.