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A comparison of sedation caused by morphine when given by the intramuscular (IM) and oral routes
A COMPARISON OF SEDATION CAUSED BY MORPHINE WHEN GIVEN BY THE INTRAMUSCULAR (IM) AND $F& ROUTES. G. R. Park, Department of Anaesthetics, Addenbrooke’s Hospital, CB2 2QQ, England. (SPON: C. Boroda) Cambridge. The use of an orally administered, long acting Aim of Investiqation: preparation of morphine (MST Napp Laboratories Ltd.) has been shown to produce more sedation that IM morphine when used to provide equivalent The aim of this experiment was to amounts of post-operative analgesia. see if this was reproducible in volunteers who had not undergone surgery. Six male volunteers were studied on two occasions separated Method: On one occasion they received 20 mg MST at the by at least two weeks. start of the experiment and on the other occasion they received 10 mg IM The order was morphine PO minutes from the start of the experiment. randomised and blind to the observer, corresponding placebos were Their sedation was assessed every 15 minutes for 6 hours administered. and scored as normal (1) relaxed (2) drowsy (3) and asleep (4). Sedation followed the administration of both IM and oral Results: morphine preparations from 105 to 285 minutes and 60 - 240 minutes respectively P <.05 (Binomial test) when compared to the pre drug state. There was a tendency for the IM morphine to produce more sedation than the oral morphine but this was not significant. The earlier work suggesting orally administered morphine Conclusion: produces more sedation than when given IM is not supported in volunteers.
THE EFFECT OF INJECTION RATE ON THE INTENSITY AND DURATION OF FIRST AND SECOND PAIN PRODUCEDBY INTRAMUSCULAR INJECTION. S. Perez, Dept of Physiological Nursing. Univ of California, San Francisco, Ca- 94143, USA -. Aim of Investigation: Utilizing an experimental design in the clinical setting, the hypothesis was tested that intramuscular injection of a medication delivered slowly, over 20 seconds, could decrease the intensity and duration of first and second pain produced by injection. Methods : Forty-eight adult males scheduled to receive a preoperative intramuscular injection of morphine sulfate were randomly assigned to one of three treatment groups. In the first group subjects received the injection over 5 seconds. The injections for the second group were given over 20 seconds. A third group served as a control with injection time monitored but not manipulated. The injection site, procedure, and injectate were identical in all groups. Pain intensity was measured at six points during and after the injection with a finger dynometer/pinch gauge. Results : When compared to injections given over 5 seconds, a Wilcoxan pairedks test revealed the slower rate of injection (20 sets) was significantly associated with a lower intensity of first and second pain produced by fluid filling and with a shorter duration of pain after injection. Conclusions: Although rate of injection does appear to influence first and second pain produced by fluid filling and duration of pain after injection, sample size was small (n=48) with distinctive characteristics that limit generalizability. A repeat study with a larger, more diverse sample is warranted.
THE EFFECT OF INJECTION RATE ON THE INTENSITY AND DURATION OF FIRST AND SECOND PAIN PRODUCEDBY INTRAMUSCULAR INJECTION. S. Perez, Dept of Physiological Nursing. Univ of California, San Francisco, Ca- 94143, USA -. Aim of Investigation: Utilizing an experimental design in the clinical setting, the hypothesis was tested that intramuscular injection of a medication delivered slowly, over 20 seconds, could decrease the intensity and duration of first and second pain produced by injection. Methods : Forty-eight adult males scheduled to receive a preoperative intramuscular injection of morphine sulfate were randomly assigned to one of three treatment groups. In the first group subjects received the injection over 5 seconds. The injections for the second group were given over 20 seconds. A third group served as a control with injection time monitored but not manipulated. The injection site, procedure, and injectate were identical in all groups. Pain intensity was measured at six points during and after the injection with a finger dynometer/pinch gauge. Results : When compared to injections given over 5 seconds, a Wilcoxan pairedks test revealed the slower rate of injection (20 sets) was significantly associated with a lower intensity of first and second pain produced by fluid filling and with a shorter duration of pain after injection. Conclusions: Although rate of injection does appear to influence first and second pain produced by fluid filling and duration of pain after injection, sample size was small (n=48) with distinctive characteristics that limit generalizability. A repeat study with a larger, more diverse sample is warranted.