Efficacy and safety of nebulized morphine given at 2 different doses compared to IV titrated morphine in trauma pain

Grissa, Mohamed Habib; Boubaker, Hamdi; Zorgati, Asma; Beltaïef, Kaouthar; Zhani, Wafa; Msolli, Mohamed Amine; Bzeouich, Nasri; Bouida, Wahid; Boukef, Riadh

doi:10.1016/j.ajem.2015.06.014

Cited by 15 publications

(21 citation statements)

References 37 publications

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“…However, administration of 10 mg of nebulized morphine provided equivalent efficacy in pain relief than IV morphine titration with fewer side effects. 11 The same findings were reported in a randomized clinical trial of Miner et al in children with acute pain comparing nebulized fentanyl citrate with fentanyl citrate administrated intravenously. They concluded that the pulmonary route of fentanyl administration might be a feasible alternative to the IV method for a variety of painful conditions in patients older than three years.…”

Section: Morphine Group Nebulized Morphine Groupsupporting

confidence: 65%

Comparing the efficacy of nebulized morphine with intravenous morphine in traumatic musculoskeletal pain management

et al. 2020

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Introduction: This study was designed to compare the effectiveness of intravenous morphine with nebulized morphine in pain relief of patients referring to the emergency setting with traumatic musculoskeletal pain. Methods: This randomized, placebo-controlled and double-blind clinical study evaluated 160 patients 18 to 65 years of age with acute traumatic pain, who attended the emergency department during 2019. Subjects were assessed with Numerical Rating Scale based on inclusion and exclusion criteria and randomly divided into two groups. In one group, 80 patients received IV morphine (0.1 mg/kg+5 mL normal saline) plus an equivalent volume of IV placebo. In the second group, 80 patients received nebulized morphine (0.2 mg/kg+5 mL normal saline) plus nebulized placebo. Pain score was monitored in all patients with Numerical Rating Scale before and after intervention at baseline, 15, 30, 45, and 60-minute intervals. Patients’ vital signs and possible adverse events were evaluated in each observation time points. Finally, all participants were assessed for their satisfaction with pain management. Data were analyzed using repeated measure analysis for continuous variables and Binomial test for categorical variables Results: There was no significant difference between the demographic characteristics of patients in study groups. Pain relief between the two groups was similar during the observation (0, 15, 30, 45, 60 min) (P>0.05). There were no changes in vital signs between two groups, although the nebulized group had lower systolic blood pressure at the time-point of 15 minutes after the treatment initiation (P=0.03). Conclusion: Although Nebulized morphine has similar efficacy in comparison with IV route, nebulization might be considered as the clinically efficacious route of morphine administration with minimal side effects, providing optimal pain relief in patients.

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Section: Morphine Group Nebulized Morphine Groupsupporting

confidence: 65%

Comparing the efficacy of nebulized morphine with intravenous morphine in traumatic musculoskeletal pain management

et al. 2020

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“…One RCT with 300 patients compared intravenous and inhaled morphine (10 or 20 mg). Inhalation of morphine was found to have efficacy comparable with that of intravenous administration, together with high safety (19). Observational studies showed that the intravenous administration of morphine can be safe and effective (30,32).…”

Section: Morphinementioning

confidence: 96%

Analgesia in Patients with Trauma in Emergency Medicine

Häske

Böttiger

Bouillon³

et al. 2017

Deutsches Ärzteblatt International

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Ketamine, fentanyl, and morphine are suitable for analgesia in spontaneously breathing trauma patients. Fentanyl and ketamine have a rapid onset of action and a strong analgesic effect. Our quantitative meta-analysis revealed no evidence for the superiority of any of the three substances over the others. Suitable monitoring equipment, and expertise in emergency procedures are prerequisites for safe and effective analgesia by healthcare professionals..

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“…Other PCA device concepts for various routes of administration have been suggested like reusable dispensers to take medication like liquids [26] or standard pills [27] orally, administer opioids through inhalation [28,29], or administer the drug through the nose [30,31]. ese concepts have either not gained significant market traction or have not been commercially developed yet.…”

Section: Technology: Safety As Itsmentioning

confidence: 99%

Quo Vadis PCA? A Review on Current Concepts, Economic Considerations, Patient-Related Aspects, and Future Development with respect to Patient-Controlled Analgesia

Nardi-Hiebl

Eberhart

Gehling

et al. 2020

Anesthesiology Research and Practice

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This review assesses four interrelating aspects of patient-controlled analgesia (PCA), a long-standing and still widely used concept for postoperative pain management. Over the years, anaesthesiologists and patients have appreciated the benefits of PCA alike. The market has seen new technologies leveraging noninvasive routes of administration and, thus, further increasing patient and staff satisfaction as well as promoting safety aspects. Pharmaceutical research focuses on the reduction or avoidance of opioids, side effects, and adverse events although influence of these aspects appears to be minor. The importance of education is still eminent, and new educational formats are tested to train healthcare professionals and patients likewise. New PCA technology can support the implementation of efficient processes to reduce workload and human errors; however, these new products come with a cost, which is not necessarily reflected through beneficial budget impact or significant improvements in patient outcome. Although first steps have been taken to better recognize the importance of postoperative pain management through the introduction of value-based reimbursement, in most western countries, PCA is not specifically compensated. PCA is still an effective and valued technique for postoperative pain management. Although there is identifiable potential for future developments in various aspects, this potential has not materialized in new products.

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Efficacy and safety of nebulized morphine given at 2 different doses compared to IV titrated morphine in trauma pain

Cited by 15 publications

References 37 publications

Comparing the efficacy of nebulized morphine with intravenous morphine in traumatic musculoskeletal pain management

Comparing the efficacy of nebulized morphine with intravenous morphine in traumatic musculoskeletal pain management

Analgesia in Patients with Trauma in Emergency Medicine

Quo Vadis PCA? A Review on Current Concepts, Economic Considerations, Patient-Related Aspects, and Future Development with respect to Patient-Controlled Analgesia

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