Acute pain management with intravenous 0.10 mg/kg vs. 0.15 mg/kg morphine sulfate in limb traumatized patients: a randomized double-blinded placebo-controlled trial.
BACKGROUND
We aimed to compare pain relief and safety of two doses of morphine in adult emergency department (ED) patients with acute limb trauma pain.


METHODS
A total of 200 adult ED patients over 20 years of age requiring opioid analgesia were randomly allocated to two groups. Following a first dose of intravenous morphine sulfate at 0.10 mg/kg, a randomized double-blind placebo-controlled trial of intravenous morphine sulfate at 0.05 mg/kg versus the same amount of placebo was performed. Measurement of visual analogue scale pain intensity and assessment of adverse effects were performed at baseline (before morphine at 0.10 mg/kg), 30 minutes from baseline (just before study drug administration), and at 60 minutes from baseline (30 minutes after study drug).


RESULTS
No significant difference was found between groups at 30 minutes from baseline. There was significant reduction in final pain after 1 hour in the 0.15 mg/kg compared to 0.10 mg/kg group (p<0.05). In addition, there was a significant improvement in the mean score of pain in the same group (p<0.05). The percent of pain reduction in the intervention and control group relative to the basic measures was 52.70% and 35.82%, respectively. Adverse effects were present in both groups; however, there was no statistically significant difference between groups.


CONCLUSIONS
Using two doses of morphine instead of one is a safe and effective method for pain reduction in isolated limb trauma. We recommend performing a second injection of 0.05 mg/kg morphine 30 minutes after the initial standard dose of 0.10 mg/kg to decrease pain in these patients.
Hazrat-e-rasool Akram Medical Complex, Tehran University of Medical Sciences, Tehran, Iran.
Davood
D
Farsi
Mitra
M
Movahedi
Peyman
P
Hafezimoghadam
Saeed
S
Abbasi
Abtin
A
Shahlaee
Vafa
V
Rahimi-Movaghar
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004636:Emergency Service, Hospital; D005121:Extremities / Q000293:injuries*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use*; D059408:Pain Management; D010147:Pain Measurement; D010148:Intractable Pain / Q000517:prevention & control*; D016896:Treatment Outcome; D014218:Triage; D014947:Wounds and Injuries
D000701:Analgesics, Opioid; D009020:Morphine