Morphine: Therapeutic use

Last modified: Saturday, 20. June 2009 - 1:06 pm

Morphine has a clear-cut place in medicine. For cancer, after surgeries, in childbirth, and even for chronic, daily headaches that resist all other treatments, morphine is effective in relieving symptoms. It is still the most widely prescribed drug for severe pain. Typical doses of morphine injected into muscle are 5-20 mg every four hours. Oral doses must be higher, between 8 and 20 mg.
Emergency use of morphine is by intravenous injection, avoiding any “first pass effect” (the “watering down” of drugs that occurs in the liver) or the time for passage through skin or muscle. This dosage is 4 — 10 mg, and the analgesia (pain relief) is nearly immediate.
Doctors may use morphine to ease childbirth. Women in early and middle labor can be given an opiate, including morphine, to be able to rest between contractions. However, giving an opioid too late into labor can make the baby sleepy on delivery. The baby may also not be able to breathe actively because morphine the morphine has slowed its respiration, but an opioid Mocker, naloxone, can be given.
Patients recovering from surgery are able to control their pain by devices called patient-controlled analgesia (PC A). PC A works by way of a pump set up by a hospital technician. The pump is then operated by the patient, who presses a button to deliver doses on demand. Morphine is commonly given in these PCA devices. Pain after certain surgeries can be further lessened by injecting very low doses of morphine into the space around the spinal cord before surgery. This can reduce the severe pain after heart surgeries, for instance, which require the surgeon to separate the breast bone.
A survey of patients in hospices published in 1999 showed that none of the 55 patients receiving 300 or more milligrams of morphine a day for pain relief had difficulty breathing because of the drug. Survival times in hospice were not any different for those on these high morphine doses.

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