title: Early administration of oral morphine to orthopedic patients after surgery.
abstract: Current pain treatment guidelines advise against providing analgesics for postoperative pain using intramuscular injections, as this generally provides poor pain relief. However, this route remains the most prevalent treatment method. Intravenous or epidural patient-controlled-analgesia methods reduce pain effectively but are expensive, labor intensive, and available to only a limited number of patients. We propose administering the analgesics using oral analgesics and have developed a simple protocol for treating postoperative pain by use of oral morphine. After a variety of orthopedic surgeries, patients were given "around-the-clock," oral, immediate-release morphine. Efficacy of the treatment (pain scores and adverse effects) was assessed 24 +/- 2 hours after surgery. Data were collected prospectively from 95 patients, who received an average of 61 +/- 30 (SD) mg morphine. Average pain scores were 2.4/10 (+/- 1.4) at rest and 4.0/10 (+/- 1.4) during movement in bed. Nausea and vomiting, the most common adverse effects, were reported by 22 (23 percent) patients. Naloxone was not administered to any of the patients. Oral morphine given in the early postoperative time to patients after a variety of orthopedic surgeries was effective and safe.
authors.affiliation: Unit for Quality Improvement, Rambam Medical Center, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa.
authors.forename: Ruth
authors.initials: R
authors.lastname: Zaslansky
authors.forename: Elon
authors.initials: E
authors.lastname: Eisenberg
authors.forename: Bezalel
authors.initials: B
authors.lastname: Peskin
authors.forename: Elliot
authors.initials: E
authors.lastname: Sprecher
authors.forename: Daniel N
authors.initials: DN
authors.lastname: Reis
authors.forename: Chaim
authors.initials: C
authors.lastname: Zinman
authors.forename: Silviu
authors.initials: S
authors.lastname: Brill
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D019637:Orthopedic Procedures / Q000009:adverse effects*; D010149:Postoperative Pain / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine