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Premedication with sublingual morphine sulphate in abdominal surgery
Laura Campiglia1, Iacopo Cappellini, Guglielmo Consales
1Department of Anaesthesia, Critical Care and Pain Therapy, Misericordia and Dolce Hospital, Prato, Italy.
Clinical Drug Investigation
|May 19, 2009
Summary
Pre-emptive analgesia with sublingual morphine sulphate effectively reduces post-operative pain in abdominal surgery patients compared to midazolam. This approach offers sustained pain relief over 48 hours with no increased side effects.
Area of Science:
- Anesthesiology
- Pain Management
- Pharmacology
Background:
- Pre-emptive analgesia, the administration of analgesics before surgery, may reduce post-operative pain.
- Existing reviews present conflicting evidence on the efficacy of pre-emptive analgesia.
Purpose of the Study:
- To evaluate the effectiveness of pre-emptive analgesia using sublingual morphine sulphate versus sublingual midazolam.
- To assess pain control in patients undergoing elective abdominal surgery.
Main Methods:
- 29 patients received either sublingual morphine sulphate (n=15) or midazolam (n=14) before surgery.
- Post-operative pain was managed with patient-controlled analgesia (PCA) morphine and acetaminophen.
- Pain was assessed using static and dynamic Visual Analogue Scales (sVAS, dVAS) and PCA usage at 4, 6, 24, and 48 hours.
Main Results:
- Group A (morphine sulphate) showed significantly lower sVAS and dVAS scores than Group B (midazolam) at all time points (p < 0.05).
- Fewer PCA doses and failed attempts were recorded in Group A compared to Group B (p < 0.05).
- No significant differences in common side effects were observed between groups.
Conclusions:
- Sublingual morphine sulphate provides superior post-operative pain control compared to sublingual midazolam in elective abdominal surgery.
- The benefits of pre-emptive sublingual morphine sulphate were evident immediately post-surgery and persisted for 48 hours.
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