Nausea and Vomiting in Postoperative Paediatric Patients With Patient-Controlled Analgesia (PCA): Morphine vs Oxycodone

Last updated: August 20, 2025
Sponsor: Murdoch Childrens Research Institute
Overall Status: Active - Recruiting

Phase

4

Condition

Vomiting

Treatment

Morphine

Oxycodone

Clinical Study ID

NCT06186141
91523
  • Ages 6-18
  • All Genders

Study Summary

POPCORN trial will compare the side effects and effectiveness of Morphine versus Oxycodone medication when prescribed for use as patient controlled analgesia (PCA) for pain relief for paediatric patients after-surgery. This trial is embedded into routine patient care using the hospital electronic medical record (EMR). Participants will be randomly assigned to either medication after they enrol in the study.

The main questions the POPCORN trial aims to answer are:

    1. Is there a difference in the usage of medication to treat nausea and vomiting for those who received oxycodone PCA versus morphine PCA for post-surgery pain relief?
    1. Is there a difference in side effects or pain relief needed between the two groups?

Study activities are as follows:

  • Participants enrolled to study during their pre-operative consultation

  • Participants are randomly assigned to morphine or oxycodone

  • No further study-specific activities expected from participant after enrolment and randomisation

  • Participant receives routine medical care as planned

  • Clinicians record assessments as per routine care in electronic medical record (EMR)

  • EMR data are extracted as trial data

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Postoperative patients who are appropriate for a PCA including those aged 6 andabove and up to age 18 years.

  • Those deemed appropriate for either morphine or oxycodone by their treatinganaesthetist.

  • American Society of Anaesthesiologists (ASA) score 1-3 inclusive

  • Those whose parents or legal guardians have provided informed consent on thepatient's behalf.

Exclusion

Exclusion Criteria:

  • Any patients with an allergy, hypersensitivity, or contraindication to morphine oroxycodone.

  • Patients in the age group with significant intellectual disability or physicalincapacity rendering them incapable of using the PCA device

  • ASA score 4 or above

  • Inability or unwillingness of parent or legal guardian to provide informed consentfor the study.

Study Design

Total Participants: 690
Treatment Group(s): 2
Primary Treatment: Morphine
Phase: 4
Study Start date:
March 13, 2024
Estimated Completion Date:
March 19, 2027

Study Description

Morphine and oxycodone are commonly used intravenous (IV) opioids in adult and paediatric post-operative patients. Traditionally, morphine has been preferentially prescribed with PCA. However, IV oxycodone is rapidly becoming more popular. Despite systematic reviews describing their use within the adult population, very little is known about the comparative side-effect profiles of morphine versus oxycodone within the paediatric post-operative population. Both options are currently in use and considered standard of care at The Royal Children's Hospital (RCH), Melbourne, Australia. However, there is limited literature to support a clinician's choice between IV oxycodone PCA versus IV morphine PCA.

The aim of this embedded randomized controlled trial is to compare the side-effect profile of IV oxycodone PCA to IV morphine PCA in post-operative paediatric patients.

This is a single site, randomised, embedded trial with two intervention arms, namely IV morphine PCA and IV oxycodone PCA. The study will not be blinded due to the need for opioid syringes to be readily identifiable on the ward. Apart from the consent and randomisation process, there will be no change to current pre-existing practices around PCA use and patient care. Adopting a health informatics approach; patient identification, consent, randomization and reporting of outcomes will be embedded within the EMR.

The primary objective is to compare antiemetic use between the two intervention arms. The secondary objectives will be a comparison of PCA side effects, efficacy and opioid use between the two arms. Outcome data must be what is already recorded as part of usual clinical care within the EMR including: antiemetic administration, respiratory depression (new oxygen and/or high dose naloxone use), urinary retention (need for in-dwelling catheter insertion), constipation (medication laxative administration), itch (RCH Itch Score (0-4 Likert scale)), nausea and vomiting, sedation (0-4 University of Michigan Scoring System), pain (Wong-Baker FACES Pain Rating Scale/Visual Analogue Scale (VAS 0-10) and total opioid consumption (mg/kg/day).

Connect with a study center

  • The Royal Children's Hospital

    Melbourne, Victoria 3052
    Australia

    Site Not Available

  • The Royal Children's Hospital

    Melbourne 2158177, Victoria 2145234 3052
    Australia

    Active - Recruiting

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