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Investigating the Safety of Post-surgical Analgesics in Children With Obstructive Sleep Apnea

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified May 2013 by Doron Sommer, Hamilton Health Sciences Corporation.
Recruitment status was:  Recruiting
The Hospital for Sick Children
University of Western Ontario, Canada
Information provided by (Responsible Party):
Doron Sommer, Hamilton Health Sciences Corporation Identifier:
First received: September 4, 2012
Last updated: May 24, 2013
Last verified: May 2013

Every year thousands of young children with obstructive sleep apnea undergo surgery which requires them to be prescribed pain medication. The current standard in North America is administration of opioids, mainly codeine or morphine; however in many areas of the world including Canada, nonsteroidal anti-inflammatory medications such as ibuprofen are used. Some North American surgeons are uncertain regarding the potential of ibuprofen to increase bleeding following surgery. The results of research studies have been inconclusive overall. Due to recent codeine fatalities in children following adenotonsillectomy, codeine has been removed from the formulary at many Pediatric institutions. Some surgeons have begun to use oral morphine as an alternate to codeine, which necessitates the need to find safe alternative analgesics in this treatment group.

The primary objectives of this study is to assess the safety(1) and efficacy (2) of morphine and ibuprofen in children with sleep apnea.

An interim analysis will be conducted after recruitment of 70 patients, to monitor both safety and efficacy

Condition Intervention Phase
Pediatric Obstructive Sleep Apnea Syndrome Drug: Morphine Drug: Ibuprofen Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Investigating the Safety of Morphine and Ibuprofen in Children Post-adenotonsillectomy for Obstructive Sleep Apnea

Resource links provided by NLM:

Further study details as provided by Doron Sommer, Hamilton Health Sciences Corporation:

Primary Outcome Measures:
  • Safety [ Time Frame: 1.5 years ]
    Safety will be assessed by comparing changes in respiratory parameters (oxygen saturation and the number of apnea events per night) following adenotonsillectomy.

Secondary Outcome Measures:
  • Effectiveness [ Time Frame: 1.5 years ]
    Analgesic effectiveness between treatment groups will be assessed using the visual analog scale and the objective pain scale

  • Risk Factors [ Time Frame: 1.5 years ]
    Age, BMI, OSA severity and genetic factors will be compared between treatment groups. Furthermore, these factors will be isolated to determine any correlation exists with respiratory parameter improvement in all enrolled patients.

Estimated Enrollment: 120
Study Start Date: May 2012
Estimated Primary Completion Date: December 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Morphine
Receives morphine for post-surgical pain
Drug: Morphine
0.2-0.5 mg/kg PO q4h
Experimental: Ibuprofen
Receives ibuprofen for post-surgical pain
Drug: Ibuprofen
10mg/kg PO q6hrs


Ages Eligible for Study:   1 Year to 10 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • diagnosed with OSAS,
  • scheduled for tonsillectomy plus/minus adenoid removal at MUMC,
  • between the ages of 1-10years

Exclusion Criteria:

  • contraindications to analgesia,
  • asthma,
  • has had previous adenotonsillectomy, or
  • any craniofacial,
  • neuromuscular or cardiac conditions
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01680939

Contact: Lauren Kelly, MSc. BMSc. PHD candidate (519) 661-2111 ext 83221

Canada, Ontario
McMaster University Medical Centre Recruiting
Hamilton, Ontario, Canada, L8N3Z5
Contact: Doron Sommer, MD         
Principal Investigator: Doron Sommer, MD FRCSC         
Sponsors and Collaborators
Hamilton Health Sciences Corporation
The Hospital for Sick Children
University of Western Ontario, Canada
  More Information

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Doron Sommer, MD, Hamilton Health Sciences Corporation Identifier: NCT01680939     History of Changes
Other Study ID Numbers: OSAS-HHSC2012
Study First Received: September 4, 2012
Last Updated: May 24, 2013

Keywords provided by Doron Sommer, Hamilton Health Sciences Corporation:
Obstructive Sleep Apnea

Additional relevant MeSH terms:
Sleep Apnea Syndromes
Sleep Apnea, Obstructive
Respiration Disorders
Respiratory Tract Diseases
Signs and Symptoms, Respiratory
Signs and Symptoms
Sleep Disorders, Intrinsic
Sleep Wake Disorders
Nervous System Diseases
Analgesics, Opioid
Central Nervous System Depressants
Physiological Effects of Drugs
Sensory System Agents
Peripheral Nervous System Agents
Anti-Inflammatory Agents, Non-Steroidal
Analgesics, Non-Narcotic
Anti-Inflammatory Agents
Antirheumatic Agents
Cyclooxygenase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action processed this record on September 21, 2017