Barriers to the use of morphine for the management of severe postoperative pain - a before and after study

International Journal of Surgery
P CoulthardD Armstrong

Abstract

To reduce the number of patients experiencing severe postoperative pain by prescribing 10 mg Morphine either as oral solution or by IM injection as an alternative to Tramadol Hydrochloride in an analgesic protocol. Patients who received in-patient oral and maxillofacial surgery under general anaesthesia were included. Complex intervention analgesic protocols were developed including staff education, patient educations and analgesic protocols. 80 patients were treated under the original protocol (tramadol hydrochloride for pain unmanaged by other drugs in protocol) over 4 months. 75 patients were treated under the second protocol (oral or intravenous morphine for pain unmanaged by other drugs in protocol). Patient perceptions to their pain management were then assessed. Proportion of patients reporting 'no pain' increased from 5% of 80 patients to 28% of 75 patients (p < 0.001). Report of severe pain reduced from 37% to 31% and not significant. Pain duration reduced from 18% to 12% for 75-100% time from surgery to discharge and not significant. Staff used protocols for 96% patients. Nurses provided patient information leaflets for 85%-80% patients. Nearly all patients (96% and 95%) reported overall satisfaction with their pain m...Continue Reading

References

Nov 14, 1992·BMJ : British Medical Journal·T H GouldJ A Webster
Dec 10, 1994·BMJ : British Medical Journal·S BrusterT L Delbanco
May 1, 1997·Anaesthesia·N B Scott, M Hodson
Nov 28, 2000·The British Journal of Oral & Maxillofacial Surgery·P CoulthardT V Macfarlane
Mar 24, 2006·Journal of Clinical Nursing·Alfhild DihleSølvi Helseth
Aug 24, 2010·The British Journal of Oral & Maxillofacial Surgery·F I J CrawfordP Coulthard

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Citations

Sep 30, 2014·Peptides·Richard J Bodnar
Oct 12, 2018·Clinical Oral Implants Research·Alexandra StähliReinhard Gruber
Jan 10, 2019·Journal of Trauma Nursing : the Official Journal of the Society of Trauma Nurses·Noordeen ShoqiratCharleen Singh

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