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Latest & greatest articles for morphine
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Randomised trial of oral morphine for chronic non-cancer pain. The use of opioid analgesics for chronic non-cancer pain is controversial. Some surveys report good pain relief and improvement in performance while others suggest a poor outcome with a propensity to psychological dependence or addiction.We undertook a randomised double-blind crossover study to test the hypothesis that oral morphine relieves pain and improves the quality of life in patients with chronic regional pain of soft tissue (...) or musculoskeletal origin who have not responded to codeine, anti-inflammatory agents, and antidepressants. Morphine was administered as a sustained-release preparation in doses up to 60 mg twice daily and compared with benztropine (active placebo) in doses up to 1 mg twice daily over three-week titration, six-week evaluation, and two-week washout phases. Pain intensity, pain relief, and drug liking were rated weekly and psychological features, functional status, and cognition were assessed at baseline
Morphine-augmented hepatobiliary scintigraphy: a meta-analysis Morphine-augmented hepatobiliary scintigraphy: a meta-analysis Morphine-augmented hepatobiliary scintigraphy: a meta-analysis Cabana M D, Alavi A, Berlin J A, Shea J A, Kim C K, Williams S V Authors' objectives To compare the sensitivity and specificity of morphine-augmented hepatobiliary scintigraphy (MA-HBS) with that of conventional hepatobiliary scintigraphy (C-HBS), in the diagnosis of acute cholecystitis. Searching MEDLINE (...) , or did not equal the sum of the patients in subgroups mentioned were excluded. Specific interventions included in the review Only studies of the diagnostic accuracy of MA-HBS and/or C-HBS were eligible for inclusion in the review. For MA-HBS a positive test had to be defined as non-visualisation of the gallbladder 20-30 min after morphine administration. For MA-HBS studies morphine augmentation had to be generally commenced 60 min after the start of the study if there was non-visualisation
Subcutaneous morphine for dyspnea in cancer patients. 8215003 1993 11 08 2013 11 21 0003-4819 119 9 1993 Nov 01 Annals of internal medicine Ann. Intern. Med. Subcutaneous morphine for dyspnea in cancer patients. 906-7 Bruera E E Edmonton General Hospital, Alberta, Canada. MacEachern T T Ripamonti C C Hanson J J eng Clinical Trial Journal Article Randomized Controlled Trial United States Ann Intern Med 0372351 0003-4819 142M471B3J Carbon Dioxide 76I7G6D29C Morphine S88TT14065 Oxygen AIM IM Ann (...) Intern Med. 1994 Apr 15;120(8):692-3 8192764 Carbon Dioxide physiology Dyspnea drug therapy etiology physiopathology Humans Injections, Subcutaneous Morphine administration & dosage Neoplasms complications Oxygen blood Respiration drug effects Terminal Care Tidal Volume 1993 11 1 1993 11 1 0 1 1993 11 1 0 0 ppublish 8215003
Preoperative morphine pre-empts postoperative pain. Postoperative analgesia is usually inadequate, perhaps because conventional approaches to pain relief do not take account of underlying mechanisms. Pre-emptive analgesia may prevent nociceptive inputs generated during surgery from sensitising central neurons and, therefore, may reduce postoperative pain. In a randomised, double-blind study, we compared the effect of parenteral morphine when given before or after total abdominal hysterectomy (...) in 60 patients. 10 mg of morphine were given intramuscularly 1 hour before operation (im pre), intravenously at induction of anaesthesia (iv pre), or intravenously at closure of the peritoneum (iv post). Response was assessed by morphine consumption from patient-controlled analgesia machines which was found to be significantly reduced in the iv pre group for 24 hours after operation compared with the iv post group. Pain sensitivity around the wound was reduced in both preoperative treatment groups
Randomised double-blind controlled trial of effect of morphine on catecholamine concentrations in ventilated pre-term babies. A sick premature baby who requires intensive care will undergo many uncomfortable procedures. It is now accepted that such babies perceive pain and need adequate analgesia, but little is known about the effects of sedation in these patients. We investigated the use of morphine to provide analgesia and sedation for ventilated preterm babies in a randomised, double-blind (...) , placebo-controlled trial. 41 mechanically ventilated babies who had been treated with surfactant (Curosurf) for hyaline membrane disease were randomly assigned morphine in 5% dextrose (100 micrograms/kg per h for 2 h followed by 25 micrograms/kg per h continuous infusion) or 5% dextrose (placebo). Plasma catecholamine concentrations were measured 1 h after the first dose of surfactant and 24 h later. Blood pressure was measured at study entry and after 6 h. The morphine and placebo groups showed
1993LancetControlled trial quality: predicted high
Halothane-morphine compared with high-dose sufentanil for anesthesia and postoperative analgesia in neonatal cardiac surgery. Extreme hormonal and metabolic responses to stress are associated with increased morbidity and mortality in sick adults. We hypothesized that administering deep opioid anesthesia to critically ill neonates undergoing cardiac surgery would blunt their responses to stress and might improve clinical outcomes.In a randomized trial, 30 neonates were assigned to receive deep (...) intraoperative anesthesia with high doses of sufentanil and postoperative infusions of opiates for 24 hours; 15 neonates were assigned to receive lighter anesthesia with halothane and morphine followed postoperatively by intermittent morphine and diazepam. Hormonal and metabolic responses to surgery were evaluated by assay of arterial blood samples obtained before, during, and after the operations.The neonates who received deep anesthesia (with sufentanil) had significantly reduced responses of beta
Morphine responsiveness of chronic pain: double-blind randomised crossover study with patient-controlled analgesia. There is controversy about whether the lack of response of some chronic pain to opioid treatment is absolute or relative. It is widely believed that nociceptive pain is responsive to opioids whereas neuropathic pain tends not to be. We have used a method of patient-controlled analgesia (PCA) with simultaneous nurse-observer measurement of analgesia, mood, and adverse effects (...) to address these issues. Ten patients with chronic pain were given morphine at two concentrations (10 and 30 mg/ml) by PCA in two separate sessions in a double-blind randomised crossover study. Before the study a clinical judgment was made as to whether each pain was nociceptive or neuropathic. Seven patients showed good analgesic responses (more than 70 mm pain relief on a visual-analogue scale) of pain at rest, two patients poor responses (less than 30 mm pain relief), and one a moderate response
Analgesic effect of intraarticular morphine after arthroscopic knee surgery. Opioids can produce potent antinociceptive effects by interacting with local opioid receptors in inflamed peripheral tissue. In this study we examined the analgesic effects of the intraarticular, as compared with intravenous, administration of morphine after arthroscopic knee surgery.In a double-blind, randomized trial, we studied 52 patients who had received one of four injections at the end of surgery. The patients (...) in group 1 (n = 18) received 1 mg of morphine intraarticularly and saline intravenously; those in group 2 (n = 15), saline intraarticularly and 1 mg of morphine intravenously; those in group 3 (n = 10), 0.5 mg of morphine intraarticularly and saline intravenously; and those in group 4 (n = 9), 1 mg of morphine and 0.1 mg of naloxone intraarticularly and saline intravenously. The volume of the intraarticular injections was 40 ml, and that of the intravenous injections was 1 ml. After 1, 2, 3, 4, 6
Epidural morphine decreases postoperative hypertension by attenuating sympathetic nervous system hyperactivity. Twenty-four adults who were undergoing operations on the abdominal aorta were enrolled in a randomized, double-blind, placebo-controlled study in which epidural morphine sulfate (6 mg) was employed to attenuate the sympathoadrenal response to surgery to evaluate the possible contribution of sympathetic nervous system hyperactivity to postoperative hypertension. Patients who received (...) epidural morphine required less parenteral morphine in the 24 hours following surgery, had lower analogue pain scores, and had markedly lower plasma norepinephrine levels when compared with patients in the control group who received an identical volume of saline in the epidural space. Epidural morphine had no effect on plasma epinephrine or arginine vasopressin levels. Fewer patients in the morphine group (4 of 12 vs 9 of 12 patients in the saline group) required treatment for hypertension (mean
Buccal morphine--a new route for analgesia? The analgesic effects of buccal and intramuscular morphine were compared in a prospective, double-blind, double-dummy study in forty patients who experienced pain after elective orthopaedic operations. Each patient simultaneously received a buccal tablet and an intramuscular injection, only one of which contained morphine sulphate (13.3 mg); the patients were randomly allocated to two equal groups so twenty patients received each active preparation (...) . The two preparations produced a similar degree of postoperative analgesia, assessed by the mean reduction in pain score and the pain relief score. Peak plasma morphine concentrations were slightly lower after buccal than after intramuscular administration but they declined more slowly; consequently, the drug's bioavailability was 40-50% greater after buccal than after intramuscular administration. The adverse effects of buccal morphine were generally less than those of intramuscular morphine.
Orally administered zomepirac and parenterally administered morphine. Comparison for the treatment of postoperative pain. A double-blind study comparing the analgesic efficacy of orally administered zomepirac sodium with intramuscularly (IM) administered morphine sulfate was conducted in 109 patients with acute postoperative pain. Single treatments were administered within 48 hours of surgery, and subjective responses were obtained from patients by specially employed trained nurses. Pain relief (...) achieved with both doses of orally administered zomepirac sodium at 100 mg and 200 mg was similar, and analgesia with each dose of zomepirac was significantly better than that obtained with IM administered morphine sulfate at 8 mg. There were no unusual side effects with either drug.
Dextroamphetamine with morphine for the treatment of postoperative pain. In a double-blind, single-dose study, dextroamphetamine combined with morphine was compared with morphine alone to determine the relative efficacy of the combination given intramuscularly for postoperative pain. Each of 450 patients received one treatment of morphine sulfate (3, 6 or 12 mg) with dextroamphetamine (0, 5 or 10 mg). Analgesia, as measured by the patients' subjective responses to questions about relief of pain (...) , was augmented when dextroamphetamine was given with morphine; the combination of dextroamphetamine, 10 mg, with morphine was twice as potent as morphine alone, and the combination with 5 mg was 1 1/2 times as potent as morphine. In simple performance tests, and in measures of side effects, dextroamphetamine generally offset undesirable effects of morphine (sedation and loss of alertness) while increasing analgesia. Effects on blood pressure, pulse and respiratory rate were minimal.