Study of Morphine in Postoperative Infants to Allow Normal Ventilation

PROTOCOL ENTRY CRITERIA:

--Disease Characteristics--

• Infants scheduled for surgery with postoperative inpatient care
• Must be born after 35 weeks or more gestational age
• No prenatal opiate exposure

Part I patients:

• Less than 12 months of age undergoing surgeries involving major thoracic, abdominal, or cardiac procedures
• No pneumonectomy, tracheal or bronchial stenosis reconstruction, diaphragmatic hernia repair, or surgeries resulting in high intraabdominal pressure (closure of large gastroschisis or omphalocele defects)
• No hepatic or renal transplantation

Part II patients:

• Less than 3 months of age undergoing surgeries using a thoracotomy approach
• Cyanotic congenital heart disease having palliative systemic to pulmonary artery shunts created OR Thoracotomy for repair of acyanotic lesions (e.g., repairs of coarctation of the aorta, tracheoesophageal fistula repair, PDA ligation)

--Patient Characteristics--

• Age: Part I: Less than 12 months Part II: Less than 3 months
• Hepatic: Normal hepatic function tests
• Renal: Normal renal function tests
• Pulmonary: No pulmonary disease causing baseline hypercarbia
• No pulmonary hypertension contraindicating use of 5% CO2 in rebreathing studies

Other:

• No allergy to morphine
• No severe developmental delay that precludes analgesia scoring