Titre du document / Document title

A multidimensional comparison of morphine and hydromorphone patient-controlled analgesia

Auteur(s) / Author(s)

RAPP S. E. ⁽¹⁾ ; EGAN K. J. ; ROSS B. K. ; WILD L. M. ; TERMAN G. W. ; CHING J. M. ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ University of Washington School of Medicine, Department of Anesthesiology, Box 356540, Seattle, WA 98195-6540, ETATS-UNIS

Résumé / Abstract

Although patient-controlled analgesia (PCA) pumps have been in use for more than a decade, the optimal PCA analgesic has yet to be identified. Many drugs are used ; however, morphine remains the gold standard of opioid analgesics worldwide. The present study evaluated morphine and hydromorphone (Dilaudid®) PCA with respect to analgesic efficacy, side effects, mood, and cognitive function. Sixty-one opioid naive patients undergoing lower abdominal surgery participated in the double-blind protocol. Verbal rating scores, use of medication, and side effects for the two medications were recorded. Cognitive functioning was assessed by computation of Digit Symbol and Trails Making B Tests. Self-reported affective state (mood) was measured by Profile of Mood States (POMS) inventory. Both medications provided adequate analgesia without a difference in side effects. Cognitive performance was poorer in the hydromorphone group (P < 0.05). Patients receiving hydromorphone reported less anger/hostility (P < 0.01) and generally better mood elevations on other subscales than those receiving morphine. A similar incidence of side effects and dose of medication can be anticipated with morphine and hydromorphone. When considering cognitive effects, morphine had less adverse consequences, while hydromorphone appeared to result in improved mood. We conclude that hydromorphone may provide a suitable alternative to morphine.

Revue / Journal Title

Anesthesia and analgesia   ISSN 0003-2999   CODEN AACRAT 

Source / Source

1996, vol. 82, n^o5, pp. 1043-1048 (24 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lippincott, Hagerstown, MD, ETATS-UNIS  (1957) (Revue)

Mots-clés anglais / English Keywords

Morphine ; Narcotic analgesic ; Comparative study ; Self administration ; Analgesia ; Chemotherapy ; Treatment ; Human ; Pain ; Postoperative ; Opiates ; Morphinan derivatives ; Surgery ;

Mots-clés français / French Keywords

Morphine ; Analgésique narcotique ; Etude comparative ; Hydromorphone ; Autoadministration ; Analgésie ; Chimiothérapie ; Traitement ; Homme ; Douleur ; Postopératoire ; Opiacés ; Morphinane dérivé ; Chirurgie ;

Mots-clés espagnols / Spanish Keywords

Analgésico narcotico ; Estudio comparativo ; Autoadministración ; Analgesia ; Quimioterapia ; Tratamiento ; Hombre ; Dolor ; Postoperatorio ; Opiados ; Cirugía ;

Localisation / Location

INIST-CNRS, Cote INIST : 3213, 35400004305810.0290