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Related Experiment Videos

Injected morphine in postoperative pain: a quantitative systematic review.

H J McQuay1, D Carroll, R A Moore

  • 1Nuffield Department of Anaesthetics, University of Oxford, Oxford Radcliffe Hospital, UK.

Journal of Pain and Symptom Management
|March 31, 1999
PubMed
Summary

Intramuscular morphine effectively relieves moderate to severe postoperative pain, with a number-needed-to-treat (NNT) of 2.9 for 50% pain relief. While minor side effects were slightly more common, overall safety was comparable to placebo.

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Area of Science:

  • Anesthesiology
  • Pharmacology
  • Pain Management

Background:

  • Postoperative pain management is crucial for patient recovery.
  • Morphine is a common analgesic, but its efficacy in specific postoperative pain scenarios requires clear quantification.
  • Systematic reviews are essential for synthesizing evidence on analgesic effectiveness.

Purpose of the Study:

  • To systematically review randomized trials assessing pain relief from morphine versus placebo in postoperative pain.
  • To quantify the efficacy of morphine using the number-needed-to-treat (NNT) for achieving at least 50% pain relief.
  • To evaluate the safety profile of morphine compared to placebo in postoperative settings.

Main Methods:

  • Systematic review of single-dose, placebo-controlled, randomized trials.

Related Experiment Videos

  • Extraction of pain relief or pain intensity difference data over 4–6 hours.
  • Calculation of relative benefit and NNT for at least 50% pain relief.

    • Main Results:

    • In 15 trials, 10 mg intramuscular morphine (486 patients) demonstrated an NNT of 2.9 (95% CI 2.6–3.6) for 50% pain relief compared to placebo (460 patients).
    • This indicates that one in three patients achieved significant pain relief with intramuscular morphine.
    • Minor adverse effects were more frequent with morphine (34%) than placebo (23%) (RR 1.49 [1.09–2.04]), but study withdrawals were similar.

    Conclusions:

    • Single-dose 10 mg intramuscular morphine provides significant pain relief for moderate to severe postoperative pain.
    • The NNT of 2.9 suggests a favorable benefit-risk profile for this analgesic approach.
    • While minor adverse events are slightly increased, morphine is generally well-tolerated postoperatively.