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Latest & greatest articles for morphine
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Ropivacaine continuous wound infusion versus epidural morphine for postoperative analgesia after cesarean delivery: a randomized controlled trial The infusion of local anesthetic in the surgical wound is helpful in the multimodal management of postoperative pain. We hypothesized that local anesthetic wound infusion after cesarean delivery would provide better pain control than epidural morphine analgesia.Healthy, term women scheduled for elective cesarean delivery were included in this assessor (...) -blinded, randomized study. Patients were randomly assigned to receive analgesia through a multiorifice wound catheter placed below the fascia and connected to a 5 mL/h ropivacaine 2 mg/mL infusion or an epidural bolus of morphine 2 mg every 12 hours. Both analgesic regimens were continued for 48 hours. The primary outcome was pain at rest at 24 hours postoperatively using the verbal rating score for pain (0-10 scale). Pain intensity, rescue analgesia consumption, and side effects were assessed at 2, 6
Cost-effectiveness of tapentadol prolonged release compared with oxycodone controlled release in the UK in patients with severe non-malignant chronic pain who failed 1st line treatment with morphine Cost-effectiveness of tapentadol prolonged release compared with oxycodone controlled release in the UK in patients with severe non-malignant chronic pain who failed 1st line treatment with morphine Cost-effectiveness of tapentadol prolonged release compared with oxycodone controlled release (...) in the UK in patients with severe non-malignant chronic pain who failed 1st line treatment with morphine Ikenberg R, Hertel N, Moore RA, Obradovic M, Baxter G, Conway P, Liedgens H Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary This study
Is intranasal fentanyl better than parenteral morphine for managing acute pain in children? BestBets: Is intranasal fentanyl better than parenteral morphine for managing acute pain in children? Is intranasal fentanyl better than parenteral morphine for managing acute pain in children? Report By: Sandeep Rahul Kusre - Senior House Officer Search checked by Jonathan Costello - Consultant A&E Institution: Royal Free Hospital Current web editor: Stewart Teece - Clinical Research Fellow Date (...) Submitted: 5th April 2009 Date Completed: 30th November 2011 Last Modified: 30th November 2011 Status: Green (complete) Three Part Question In [children presenting to Accident & Emergency in acute pain] is [intranasal fentanyl a better analgesic than intravenous or intramuscular morphine] at [reducing pain] Clinical Scenario A child presents to the paediatric emergency department in acute pain but you cannot give him intranasal diamorphine due to both a departmental and nationwide shortage. You are able
Fentanyl Pectin Nasal Spray reduces breakthrough cancer pain intensity compared with placebo in people taking at least 60 mg daily oral morphine or equivalent. 21561853 2011 10 26 2011 06 10 1468-9618 14 3 2011 Jul Evidence-based nursing Evid Based Nurs Fentanyl Pectin Nasal Spray reduces breakthrough cancer pain intensity compared with placebo in people taking at least 60 mg daily oral morphine or equivalent. 90-1 10.1136/ebn1150 Curtiss Carol P CP Tufts University Medical School, Boston
Morphine Sulfate Drug Approval Package: Morphine Sulfate NDA #202515 Drug Approval Package U.S. Food & Drug Administration Search FDA Drug Approval Package - Morphine Sulfate Company: Hospira, Inc. Application No.: 202515 Approval Date: 11/14/2011 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) Date created: June 26, 2012 Vision impaired people having problems
Morphine Sulfate Oral Solution Drug Approval Package: Morphine Sulfate NDA #201517 Drug Approval Package U.S. Food & Drug Administration Search FDA Drug Approval Package - Morphine Sulfate Oral Solution, 100 mg per 5 mL (20 mg per mL) Company: Lannett Holdings, Inc. Application No.: 201517 Approval Date: 06/23/2011 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. (PDF) (PDF) (PDF) (PDF) (P (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF
Comparative clinical effects of hydromorphone and morphine: a meta-analysis Comparative clinical effects of hydromorphone and morphine: a meta-analysis Comparative clinical effects of hydromorphone and morphine: a meta-analysis Felden L, Walter C, Harder S, Treede RD, Kayser H, Drover D, Geisslinger G, Lotsch J CRD summary The authors concluded that hydromorphone may have been a slightly more effective pain-killer than morphine, but further studies were needed to confirm this. In view (...) of the limited number and size of the trials, heterogeneity and limited size of the effects, the conclusions may not be sufficiently cautious and it is unclear whether they are reliable. Authors' objectives To compare the clinical benefits of hydromorphone with morphine to relieve pain. Searching PubMed and EMBASE were searched for studies published between 1970 and June 2009. References of included studies were also searched. Authors were contacted for additional data. Search terms were reported. Study
NMDA-receptor antagonist and morphine decrease CRPS-pain and cerebral pain representation A combination therapy of morphine with an NMDA-receptor antagonist might be more effective than morphine without a NMDA-receptor antagonist for the relief of neuropathic pain in patients with complex regional pain syndrome (CRPS). In order to test the efficacy of this combination therapy we performed a double-blind randomized placebo-controlled study on patients suffering from CRPS of the upper extremity (...) . We used functional magnetic resonance imaging during movement of the affected and unaffected upper hand before and after a treatment regimen of 49 days that contrasted morphine and an NMDA-receptor antagonist with morphine and placebo. We postulated superior pain relief for the combination therapy and concomitant changes in brain areas associated with nociceptive processing. Only the combination therapy reduced pain at rest and during movement, and disability. After treatment, activation
Sufentanil is not superior to morphine for the treatment of acute traumatic pain in an emergency setting: a randomized, double-blind, out-of-hospital trial We determine the best intravenous opioid titration protocol by comparing morphine and sufentanil for adult patients with severe traumatic acute pain in an out-of-hospital setting, with a physician providing care.In this double-blind randomized clinical trial, patients were eligible for inclusion if aged 18 years or older, with acute severe (...) pain (defined as a numeric rating scale score ≥ 6/10) caused by trauma. They were assigned to receive either intravenous 0.15 μg/kg sufentanil, followed by 0.075 μg/kg every 3 minutes or intravenous 0.15 mg/kg morphine and then 0.075 mg/kg. The primary endpoint of the study was pain relief at 15 minutes, defined as a numeric rating scale less than or equal to 3 of 10. Secondary endpoints were time to analgesia, adverse events, and duration of analgesia during the first 6 hours.A total of 108
Intranasal fentanyl or diamorphine versus intravenous morphine for analgesia in adults BestBets: Intranasal fentanyl or diamorphine versus intravenous morphine for analgesia in adults Intranasal fentanyl or diamorphine versus intravenous morphine for analgesia in adults Report By: Lee Helliwell - SpR Emergency Medicine Search checked by Catherine Jackson - ST5, Emergency Medicine Institution: Lancashire Teaching Hospitals NHS Trust Current web editor: Richard Body - Clinical Research Fellow (...) Date Submitted: 8th December 2009 Date Completed: 7th September 2010 Last Modified: 8th September 2010 Status: Green (complete) Three Part Question In [adults presenting to the Emergency Department in pain] is [intranasal fentanyl superior to intravenous morphine] at [reducing pain]? Clinical Scenario It is 7:45am and you are just winding down with a coffee before the end of a shift and the doors to the Emergency Department (ED) burst open. Lying on a stretcher is a young, obese lady who
The analgesic efficacy of subarachnoid morphine in comparison with ultrasound-guided transversus abdominis plane block after cesarean delivery: a randomized controlled trial Ultrasound-guided transversus abdominis plane block is an effective method of providing pain relief after cesarean delivery. Neuraxial morphine is currently the "gold standard" treatment for pain after cesarean delivery. In this study we tested the hypothesis that subarachnoid morphine would provide more prolonged (...) and superior analgesia than would transversus abdominis plane block in patients undergoing elective cesarean delivery.In this prospective, double-blind study, 57 patients were randomly assigned to receive either subarachnoid morphine (group SAM; n = 28) or transversus abdominis plane block (group TAP; n = 29). Patients received bupivacaine spinal anesthesia combined with morphine 0.2 mg in group SAM and received saline in group TAP. At the end of surgery, bilateral transversus abdominis plane block
ALO-01 (morphine sulfate and naltrexone hydrochloride) extended-release capsules in the treatment of chronic pain of osteoarthritis of the hip or knee: pharmacokinetics, efficacy, and safety ALO-01 (EMBEDA [morphine sulfate and naltrexone hydrochloride] extended-release capsules [King Pharmaceuticals, Inc, Bridgewater, NJ]), indicated for chronic moderate-to-severe pain, is designed to release naltrexone upon tampering (eg, by crushing), reducing morphine-induced subjective effects (...) . This multicenter, randomized, double-blind, crossover study assessed pharmacokinetics, efficacy, and safety of ALO-01 and compared them with extended-release morphine sulfate (ERMS, KADIAN [morphine sulfate extended-release] capsules [Actavis US, Morristown, NJ]) in adults (N = 113) with osteoarthritis pain. Study periods included washout until pain flare (intensity > or =5, 0 to 10; 0 = no pain, 10 = worst pain); dose titration with ERMS (20 to 160mg BID); and randomization to 2 (crossover) 14-day treatment
A randomized, double-blind, placebo-controlled trial of epidural morphine analgesia after vaginal delivery Pain after vaginal delivery can interfere with the activities of daily living. We hypothesized that epidural medication administered after delivery would be of benefit for acute postpartum pain management. The objective of this study was to assess whether epidural morphine after vaginal delivery would reduce the analgesic requirements for perineal pain.This randomized, double-blind (...) , placebo-controlled trial included 228 parturients who received epidural morphine, 2.5 mg, or epidural saline within 1 h of delivery. The primary outcome was the proportion of women who received additional analgesics in the first 24 h postpartum. We also evaluated the time to first request for analgesia, pain and satisfaction scores, and the incidence of side effects due to epidural morphine.The majority of the 228 women participating in the study were Caucasian, primiparous patients >30 yr old
Morphine use after combat injury in Iraq and post-traumatic stress disorder. Post-traumatic stress disorder (PTSD) is a common adverse mental health outcome among seriously injured civilians and military personnel who are survivors of trauma. Pharmacotherapy in the aftermath of serious physical injury or exposure to traumatic events may be effective for the secondary prevention of PTSD.We identified 696 injured U.S. military personnel without serious traumatic brain injury from the Navy-Marine (...) Corps Combat Trauma Registry Expeditionary Medical Encounter Database. Complete data on medications administered were available for all personnel selected. The diagnosis of PTSD was obtained from the Career History Archival Medical and Personnel System and verified in a review of medical records.Among the 696 patients studied, 243 received a diagnosis of PTSD and 453 did not. The use of morphine during early resuscitation and trauma care was significantly associated with a lower risk of PTSD after
Intravenous paracetamol or morphine for the treatment of renal colic: a randomized, placebo-controlled trial This randomized, placebo-controlled trial evaluates the analgesic efficacy and safety of intravenous single-dose paracetamol and morphine for the treatment of renal colic.We conducted a randomized, double-blind, placebo-controlled clinical trial comparing single intravenous doses of paracetamol (1 g), morphine (0.1 mg/kg), and placebo (normal saline solution) for patients presenting (...) because of uncertain diagnoses, leaving 146 subjects available for analysis. The mean reduction in visual analogue scale pain intensity scores at 30 minutes was 43 mm for paracetamol (95% confidence interval [CI] 35 to 51 mm), 40 mm for morphine (95% CI 29 to 52 mm), and 27 mm for placebo (95% CI 19 to 34 mm). Statistically significant mean differences in pain intensity reductions compared with those for placebo were observed for paracetamol (16; 95% CI 5 to 27; P=.005) and morphine (14; 95% CI 0.4
A randomized controlled trial of pentazocine versus ondansetron for the treatment of intrathecal morphine-induced pruritus in patients undergoing cesarean delivery Ondansetron is effective for the treatment of intrathecal morphine-induced pruritus. There is evidence that kappa-opioid receptor agonists have antipruritic activity. Pentazocine is an agonist of kappa-opioid receptors and partial agonist at mu-opioid receptors. We therefore performed a randomized, double-blind trial to compare (...) the efficacy of pentazocine and ondansetron for the treatment of pruritus associated with intrathecal injection of morphine in patients undergoing cesarean delivery.Two hundred eight parturients who developed moderate to severe pruritus after the administration of intrathecal morphine were randomly allocated to 2 groups: IV pentazocine 15 mg (n = 104) and IV ondansetron 4 mg (n = 104). The successful treatment of pruritus (no or mild pruritus) and other adverse effects were determined 15 min after study
Paracetamol and selective and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) for the reduction of morphine-related side-effects after major surgery: a systematic review Paracetamol and selective and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) for the reduction of morphine-related side-effects after major surgery: a systematic review Paracetamol and selective and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) for the reduction of morphine-related side (...) -effects after major surgery: a systematic review McDaid C, Maund E, Rice S, Wright K, Jenkins B, Woolacott N Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation McDaid C, Maund E, Rice S, Wright K, Jenkins B, Woolacott N. Paracetamol and selective and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) for the reduction of morphine-related
Analgesic efficacy and adverse effects of epidural morphine compared to parenteral opioids after elective caesarean section: a systematic review Analgesic efficacy and adverse effects of epidural morphine compared to parenteral opioids after elective caesarean section: a systematic review Analgesic efficacy and adverse effects of epidural morphine compared to parenteral opioids after elective caesarean section: a systematic review Bonnet MP, Mignon A, Mazoit JX, Ozier Y, Marret E CRD summary (...) The authors concluded that epidural morphine after caesarean section increased the time to first request for a rescue analgesic (limited to the first postoperative day) and decreased pain postoperatively, but increased the risks of nausea and pruritus. Apart from some limitations in reporting of the review process, the authors' conclusions reflect the reasonable quality evidence presented and seem reliable. Authors' objectives To evaluate the analgesic effectiveness and side effects of epidural morphine
Morphine-based cardiac anesthesia provides superior early recovery compared with fentanyl in elective cardiac surgery patients Experimental and clinical data suggest that morphine possesses unique cardioprotective and antiinflammatory properties. In this clinical investigation, we sought to determine whether the choice of intraoperative opioid (morphine or fentanyl) influences early recovery after cardiac surgery.Ninety patients undergoing cardiac surgery with cardiopulmonary bypass were (...) randomized to receive either morphine (40 mg) or fentanyl (600 mug) as part of a standardized opioid-isoflurane anesthetic. Quality of recovery was assessed using the QoR-40 questionnaire administered preoperatively and daily on postoperative days 1-3. During the first three postoperative days, pain was measured using a 100-mm visual analog scale, and the use of IV and oral pain medications (morphine or acetaminophen/hydrocodone) was quantified. Hemodynamic variables, duration of tracheal intubation