Peripheral morphine analgesia in dental surgery

Area of Science:

• Pharmacology
• Pain Management
• Anesthesiology

Background:

• Opioid receptors are present on peripheral nerve endings, supporting peripheral analgesic effects of local opioids.
• Inflammatory conditions enhance the efficacy of peripheral opioid analgesia.
• Previous studies demonstrated intraarticular morphine's effectiveness in knee surgery pain.

Purpose of the Study:

• To investigate the efficacy of direct morphine infiltration for inflammatory tooth pain following dental surgery.
• To evaluate postoperative pain intensity and analgesic consumption after local morphine administration.

Main Methods:

• A prospective, randomized, double-blind study involving 44 dental surgery patients.
• Patients received either 1 mg of morphine or saline with standard local anesthetic (articaine plus epinephrine).
• Postoperative pain was assessed using visual analog scale (VAS) and numeric rating scale (NRS) up to 24 hours.

Main Results:

• Morphine group showed significantly lower pain scores from 8 to 24 hours postoperatively compared to the saline group.
• Patients receiving morphine required less supplemental diclofenac and had a delayed first analgesic intake.
• No serious side effects were reported in either group.

Conclusions:

• 1 mg of morphine, when added to local anesthetics for dental surgery, significantly enhances postoperative analgesia.
• Direct morphine infiltration is a promising strategy for managing inflammatory dental pain.
• Supplemental morphine may be beneficial for patients undergoing dental procedures with inflammatory reactions.