Analgesic efficacy of perioperative buccal morphine

We have studied the effect of regular perioperative administration of buccal morphine sulphate on postoperative analgesic consumption in female patients undergoing lower abdominal surgical procedures. Ten matched pairs of women were allocated randomly to receive either placebo or buccal morphine before operation and at 12-h intervals up to 44 h after operation. Pain was assessed using a visual analogue scale and taste assessed using evaluation forms. Postoperative analgesic requirements were compared using a patient-controlled analgesia system which was set to deliver bolus doses of pethidine without a background infusion. There was no significant difference in pain scores between the two groups. Compared with placebo, buccal morphine did not reduce significantly postoperative pethidine consumption. All patients receiving buccal morphine reported a taste which reduced its acceptability.