title: Single-dose extended-release epidural morphine for pain following hip arthroplasty.
abstract: This open-label, serial-cohort pilot study evaluated DepoDur, a new, single-dose, extended-release epidural morphine (EREM) for pain control after hip arthroplasty. Single-dose EREM (10-30 mg) or a single dose of standard morphine sulfate (MS) (5 mg) was administered before surgery and spinal anesthesia. Among the 39 patients enrolled, total 48-hour supplemental fentanyl use was lower (P = 0.011 overall treatment) and median time to first postoperative fentanyl use was three- to six-fold longer (P < 0.001 overall treatment), among 10-, 20-, and 30-mg single-dose EREM patients versus MS patients. EREM patients reported higher levels of satisfaction with pain intensity scores comparable to MS patients. Safety results were similar between groups. Single-dose EREM was generally safe and effective for treating postoperative pain and reduced the need for supplemental analgesia.
authors.affiliation: Department of Anesthesiology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA. eugene.viscusi@jefferson.edu
authors.forename: Eugene R
authors.initials: ER
authors.lastname: Viscusi
authors.forename: Dan
authors.initials: D
authors.lastname: Kopacz
authors.forename: Craig
authors.initials: C
authors.lastname: Hartrick
authors.forename: Gavin
authors.initials: G
authors.lastname: Martin
authors.forename: Garen
authors.initials: G
authors.lastname: Manvelian
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D000775:Anesthesia, Spinal; D019644:Arthroplasty, Replacement, Hip; D015331:Cohort Studies; D003692:Delayed-Action Preparations; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010865:Pilot Projects; D011446:Prospective Studies; D012129:Respiratory Function Tests
chemical_list: D000701:Analgesics, Opioid; D003692:Delayed-Action Preparations; D009020:Morphine; D005283:Fentanyl