Related Experiment Video
Updated: Jun 24, 2026
06:59
A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Nebulized morphine for analgesia in an emergency setting
Vincent Bounes1, Jean Louis Ducassé, Annie Momo Bona
1Pôle de Médecine Dúrgences Hôpitaux Universitaries, France.
Journal of Opioid Management
|April 7, 2009
Summary
Inhaled morphine at 0.2 mg/kg did not effectively relieve severe acute pain in an emergency setting. This study suggests intravenous opioids are more appropriate for managing acute pain emergencies.
Area of Science:
- Emergency Medicine
- Pharmacology
- Pain Management
Background:
- Severe acute pain in emergency settings presents a significant clinical challenge.
- Effective pain management is crucial for patient comfort and outcomes.
- The pulmonary route for drug delivery offers potential advantages, including rapid absorption.
Purpose of the Study:
- To assess the efficacy and safety of nebulized morphine for severe acute pain in an emergency department.
- To determine if inhaled morphine can provide clinically significant pain relief.
Main Methods:
- A study involving 28 adult patients with severe acute pain (Numerical Rating Scale [NRS] score ≥ 60/100).
- Administration of a single 0.2 mg/kg dose of nebulized morphine.
- Pain scores (NRS) were recorded at baseline and at 1, 3, 5, and 10 minutes post-inhalation.
Main Results:
- No patients achieved the primary outcome of pain relief (NRS ≤ 30/100) at 10 minutes.
- A statistically significant reduction in pain scores was observed, but it did not meet the minimum clinically significant difference.
- No adverse events were reported during the study.
Conclusions:
- Nebulized morphine at 0.2 mg/kg is ineffective for managing severe acute pain in emergency settings.
- Intravenous administration of opioids at fixed intervals is recommended for severe acute pain management in emergencies.
Related Concept Videos
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
01:24Parenteral Anesthetics: Overview
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
01:18Drug Delivery: Enteral Route
The enteral drug administration involves three primary routes: oral, sublingual, and buccal. Oral ingestion is the most prevalent, safe, economical, and convenient method for drug administration. However, it has certain drawbacks, including limited absorption due to the drug's low water solubility or poor membrane permeability, possible emesis from GI mucosa irritation, destruction of drugs by digestive enzymes or low gastric pH, and irregular absorption along with food or other drugs.
Drugs in...
Drugs in...
01:25Analgesia and Pain Management
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
01:30Adrenergic Agonists: Therapeutic Uses
Adrenergic agonists have diverse therapeutic uses across various medical conditions and emergencies.
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and anaphylaxis:...
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and anaphylaxis:...