Retrospective Analysis of Single-Dose Extended-Release Epidural Morphine Usage

Abstract

Objective: Moderate to severe postoperative pain is commonly experienced by surgical patients. A new advance in epidural anesthesia permits use of a 48 hour, extended release formulation of morphine (DepoDur TM ). This retrospective study examines efficacy and side effects of this drug used in two different doses.Methods: 90 surgical patients were given Epidural analgesia, of which 31 and 59 patients were given single doses of 10 mg or 15 mg extended release formulations of morphine respectively. Following IRB approval, retrospective chart review focusing on supplemental pain medication needs of patients up to the first 48 hours after surgery was carried out. Pain medication doses were converted to morphine equianalgesic values using established equivalence formulas. Verbal analog pain scale records from postoperative recovery units were reviewed; side effects of patients were noted.Results: During the first 48 hours after surgery, patients given 10 mg dosage of DepoDur TM required 27.3 ± 32.8 mg while those given 15 mg of DepoDur TM required 19.6 ± 18.2 mg of morphine (P = 0.23). Pain levels reported on a 0-10 scale at discharge after surgery were 1.6 ± 2.6 and 0.9 ± 1.5 for the 10 mg and 15 mg groups respectively (P = 0.52). Postoperative side effects were experienced in 77% and 68% of patients receiving a 10 mg and 15 mg dose of DepoDur TM respectively (P = 0.46). Postoperative nausea was reported with greater frequency at 65% and 46% in both 10 mg and 15 mg groups respectively (P = 0.12). Conclusion:Comparing usage of 10 mg and 15 mg doses of DepoDur TM for extended release epidural analgesia, no significant difference was found in pain control, total pain medicine consumption during the first 48 hours after surgery and or incidence of any side effect.