Postoperative titration of intravenous morphine

Abstract

Intravenous morphine titration every 5 min with an unlimited number of boluses and early subcutaneous administration provided the best analgesic regimen.

One half of patients reports persistent pain three months after orthopaedic surgery

“…Indeed, we used multimodal analgesia as recommended by the French guidelines, with postoperative intravenous morphine titration as necessary [33] and continuous regional analgesia techniques as frequently as possible. Improving such results should be a priority.…”

Do Postoperative Pain Management Techniques Influence Postoperative Delirium?

“…After single intravenous (IV) injection of morphine, there is a 50 % reduction of apparent volume of distribution at steady state, and reduction of plasma clearance compared with young subjects [24]. For acute pain management, drug titration, especially IV opioid titration is encouraged to relieve acute postoperative pain because it quickly meets the needs of individual patients and limits the risk of overdose [25]. Among opioids analgesics, meperidine is known to be significantly associated with POD, if administered within 24 h of a delirious episode or at any time during postoperative days 1-3 for nondelirious subjects in both younger and older patients [26][27][28].…”

Douleur sévère et morphine aux urgences chez le patient âgé

“…L'échelle de Boureau [11], qui cote quatre items de 0 à 3, semble plus adaptée à la cotation de la douleur aiguë, mais moins connue. Une échelle d'observation comportementale (EOC) s'en inspire dans quelques travaux [19,20]. Les propositions de score se multiplient dans la littérature, inspirées de la pratique pédiatrique.…”

“…Dans le cadre d'une hospitalisation, certains proposent de débuter le relais antalgique deux heures après la fin d'une « hétérotitration » [19,20,39]. Si la douleur est toujours très intense et qu'elle varie énormément au cours du nycthémère, la PCA semble une bonne solution.…”