MORPHINE: OTHER ROUTES OF ADMINISTRATION-INTRAVENOUS MORPHINE

Single or repeated intravenous injections of morphine are the most efficient means of controlling severe or acute pain. The dose used depends on the patient's previous exposure to opioid drugs and on the effect; if the initial injection fails to control the pain, further injections can be given at intervals of 15-20 minutes.

Continuous intravenous infusions of morphine may be used where intravenous access has been established for other reasons, as in the postoperative phase or in patients with catheters previously used for chemotherapy! The efficacy of continuous subcutaneous infusions means it is never necessary to initiate intravenous therapy solely for the purpose of a morphine infusion. Calculation of the dose of morphine for a 24-hour infusion is the same as given above for subcutaneous morphine.

Intravenous infusion may be combined with patient controlled analgesia (PCA), in which the infusion pump includes a device which allows the delivery of an extra small bolus, on demand. PCA is effective in the management of postoperative pain but its role in patients with advanced cancer has not been established.

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Pain Relief/Muscle Relaxers