Intraspinal use of morphine.
OBJECTIVE
To compare the different sterility standards and the cost issues involved when choosing an opioid product for intraspinal administration.


METHODS
Literature accessed through MEDLINE and other Internet search engines (September 2002-April 2003) was evaluated. Key search terms included epidural/intrathecal, opioids, sterility, and compounding.


RESULTS
Intraspinal use is prevalent in the area of pain management. Product selection is of utmost importance when administering through the intraspinal route. An evaluation of guidelines on sterility and a cost comparison were conducted.


CONCLUSIONS
The preservative-free commercially available products that are indicated for intrathecal/epidural use are the best alternative due to proper outside testing and stringent quality assurance. The generic morphine preservative-free product may also be considered if proper steps are taken to ensure that the final product is diluted properly.
Gaudette
Kathryn E
KE
H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612-9497, USA. katiegaudette@hotmail.com
Weaver
S Jay
SJ
D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D000767:Anesthesia, Epidural; D004339:Drug Compounding; D006801:Humans; D007278:Injections, Spinal; D009020:Morphine / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy; D013242:Sterilization; D014481:United States; D014486:United States Food and Drug Administration
D000701:Analgesics, Opioid; D009020:Morphine