Morphine based anesthetic allows early discharge from the intensive care unit in Children undergoing cardiac surgery

Introduction: at our institution morphine was not being used as a part of balanced anesthetic technique because of fear of delayed extubation and prolonged mechanical ventilation. nalbuphine is the most commonly used opioid at our institution and has been the sole opioid used in pediatric cardiac surgery procedures up until recently. we retrospectively compared the icu stay of children who underwent cardiac surgery with either morphine as their sole opioid or nalbuphine. materials and methods: a retrospective review of all patients undergoing corrective or palliative cardiac surgery for a congenital cardiac anomaly from december 1,2010 through may 2011 was done. patients were categorized into two groups,group a received morphine and group b received nalbuphine. results: a total of 144 patients qualified for the study. group a. the morphine group,had 23 patients,while group b had 121 patients. for group a the overall mean icu stay was 2.56 days (1-10 days) for the whole group,for closed heart procedures the mean icu stay was 2.42 days (1-10 days) and for open heart procedures mean icu stay was 2.6 days (1-5 days range). for group b patients the mean icu stay for the whole group was 3.14 days (0-39 days range). the mean icu stay for closed heart procedures was 2.6 days (0-39 days) and 3.66 days (1-25 days) for open heart procedures. statistical analyses were performed on a personal computer with the statistical package spss for windows (version 13.0,spss,chicago). statistical analysis revealed that the mean duration of stay in the icu was shorter in group a and this did approach statistical significance (p=0.075,95% ci: 1.6-7.89. the icu stay for open heart procedures was shorter in group a and also approached statistical significance. conclusions: in children undergoing open and closed heart surgeries,morphine based anesthetic does not delay icu stay when compared to nalbuphine and data analysis suggests that morphine based anesthesia may shorten icu stay in selected patients undergoing cardiac surgery.