36903
document
A controlled comparison between single doses of intravenous and intramuscular morphine with respect to analgesic effects and patient safety . UNLABELLED BACKGROUND AND AIM OF INVESTIGATION : Intramuscular ( IM ) administration has been considered to be safer than intravenous ( IV ) for opioids on wards , but a comparative knowledge of patient safety and analgesic potency following a single dose of IV and IM administration is lacking . This study was carried out to compare patient safety and analgesic efficacy of a single and high dose of morphine given IM or IV for post-operative pain management . MATERIALS AND METHODS Thirty-eight patients with post-operative pain following hip replacement surgery were given IM or IV morphine 10 mg at a specified pain level . The study was randomized and double blinded . Time to onset of analgesic effect ( 11-point numeric rating scale ) , respiratory function ( p ( a ) CO2 , p ( a ) O2 , and respiratory rate ) , level of sedation ( 5-point verbal rating scale ) , and hemodynamic function were recorded . RESULTS In the IV group there was a slight but significant increase in p ( a ) CO2 after 5 , 10 , and 15 min compared with the IM group ( 5.2 vs. 4.8 , 5.4 , vs. 5.0 and 5.5 vs. 5.1 kPa , respectively ) . The IV group had a significantly faster onset of analgesic effect than the IM group ( 5 vs. 20 min ) . Between 5 and 25 min after morphine administration , pain status in the IV group was significantly improved compared with the IM group . Patients in the IV group were slightly more sedated than the IM group 5 and 10 min after morphine . CONCLUSION A 10 mg bolus dose of IV morphine given to patients with moderate pain after surgery does not cause severe respiratory depression , but provides more rapid and better initial analgesia than 10 mg given IM . IV morphine even at a dose as high as 10 mg IV is well tolerated if there is a certain level of pain at its administration . The safety of IV morphine on the general ward needs to be further explored in adequately controlled studies .
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Intervention_Pharmacological
intravenous and intramuscular morphine
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Intervention_Pharmacological
opioids
36906
Intervention_Pharmacological
morphine given IM or IV
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Intervention_Surgical
hip replacement surgery
36908
Intervention_Pharmacological
IM or IV morphine
36909
Intervention_Pharmacological
morphine
36910
Intervention_Surgical
surgery
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Intervention_Pharmacological
morphine
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Intervention_Pharmacological
morphine
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Outcome_Other
analgesic effects
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Outcome_Other
patient safety .
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Outcome_Other
patient safety
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Outcome_Other
analgesic potency
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Outcome_Other
patient safety and analgesic efficacy
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Outcome_Physical
Time to onset of analgesic effect ( 11-point numeric rating scale ) , respiratory function ( p ( a ) CO2 , p ( a ) O2 , and respiratory rate ) , level of sedation ( 5-point verbal rating scale ) , and hemodynamic function
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Outcome_Physical
onset of analgesic effect
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Outcome_Pain
pain status
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Outcome_Physical
sedated
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Outcome_Physical
severe respiratory depression
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Outcome_Physical
initial analgesia
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Outcome_Other
tolerated