Paediatric anaesthesia & critical care
Intrathecal Hydromorphone Dosing for Adolescent Spinal Fusion: A Prospective Dose‐Escalation Study
Authors' conclusion
Increasing ITH dose was not associated with improved analgesia or change in supplemental opioid or diazepam use. Doses > 5 mcg kg-1 were associated with adverse respiratory effects. These findings support conservative dosing strategies and underscore the need to define the minimum effective dose in pediatric populations.
Study context
- Population
- Patients aged 10–17 years undergoing posterior spinal fusion (PSF)completed the study
- Participants
- Twenty-seven patients
- Exposure
- Relationship between intrathecal hydromorphone (ITH) dose, analgesia, and adverse effects
- ITHn = Twenty-seven
- Outcome
- Maximum postoperative pain
- Follow-up
- Within 18 h
Methodological detailsbiased-coin up-down sequential allocation design
- Biased-coin up-down sequential allocation design
Main finding
As reported in the abstract
Spearman correlation between ITH dose and maximum pain, r
0.16
p
0.41
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (per unit of ITH dose (unit not stated)) (95% CI) | P value | |
|---|---|---|---|
| Time to rescue opioidNot significantly associated | 1.24 (0.68–2.25) | P = 0.485 | |
| Time to diazepamNot significantly associated | 1.10 (0.72–1.71) | P = 0.655 | |
| 0.512Hazard ratio (log scale) |
Pain burden (area under the curve)
- Spearman correlation between ITH dose and pain burden, r
- 0.32
- p
- 0.10
- No significant association
24-h systemic opioid consumption (OME, excluding ITH)
- Spearman correlation between ITH dose and 24-h OME, r
- 0.13
- p
- 0.52
- No significant association
ITH dose received
- Median ITH dose, mcg kg-1 (IQR, 3.5-7.0)
- 5.5
- Median absolute dose, mcg (IQR, 180-400)
- 370
Safety
Adverse respiratory events
- Occurred at doses > 5 mcg kg-1 without improved analgesia
Original publication
Intrathecal Hydromorphone Dosing for Adolescent Spinal Fusion: A Prospective Dose‐Escalation Study. Paediatr Anaesth. Published 7 October 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →