Side Effects of morphine rectal: A Synthesis of Findings from 12 Studies

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Original Abstract of the Article

Major Research Findings

Several studies have investigated ways to reduce the side effects of morphine, a medication widely used for pain management. One study, 9 , found that epidural naloxone was effective in reducing itching caused by epidural morphine. Another study, 5 , showed that epidural naloxone reduced itching and nausea without affecting the pain relief provided by epidural morphine. In addition, 1 explored the potential of combining butorphanol with epidural morphine to minimize side effects in pediatric patients. This study aimed to determine if this combination could reduce the frequency of side effects associated with neuraxial opioids.

Other studies have focused on alternative approaches to manage morphine-related side effects. For instance, 11 investigated the use of a low-dose naloxone infusion to alleviate nausea and sedation caused by intravenous tramadol without compromising its pain relief effects. A separate study, 4 , explored the potential of nalmefene, an opioid antagonist, to prevent morphine-related side effects in patients receiving intravenous patient-controlled analgesia. 3 compared the effectiveness of intravenous infusions of nalbuphine or naloxone in preventing epidural morphine-related side effects.

Overall, these studies highlight the multifaceted nature of morphine side effects and the ongoing search for effective strategies to mitigate them. While naloxone appears to hold promise in reducing certain side effects, further research is needed to refine its use and explore other potential interventions.

Reasons for Side Effects

Morphine's side effects are attributed to its interaction with opioid receptors in the brain. These receptors are involved in regulating various functions, including pain, mood, breathing, and digestion. When morphine binds to these receptors, it can alter these functions, leading to side effects.

Common Side Effects

Itching

Itching is one of the most frequent side effects of morphine. It's thought to be caused by morphine's ability to stimulate the release of histamine, a substance that triggers itching and other allergic reactions. 9 and 5 highlight the effectiveness of naloxone in reducing morphine-induced itching.

Nausea and Vomiting

Morphine can also cause nausea and vomiting. This is believed to result from the stimulation of the brain's vomiting center by morphine. Morphine can also slow down stomach activity, potentially aggravating nausea.

Drowsiness

Drowsiness is a common side effect of morphine. It's thought to occur because morphine suppresses the brain's respiratory center. Furthermore, morphine can impair concentration and judgment, making it unwise to engage in activities that require alertness, such as driving or operating machinery.

Constipation

Morphine can lead to constipation due to its ability to slow down bowel movement. Staying hydrated, consuming fiber-rich foods, and consulting with a doctor for possible laxative options can help prevent and manage constipation.

Respiratory Depression

Morphine can suppress breathing, a potentially serious side effect. Monitoring your breathing and seeking immediate medical attention if you experience shallow or infrequent breathing is crucial.

Managing Side Effects

Itching

Antihistamines can help reduce morphine-induced itching. 9 and 5 suggest that naloxone can effectively alleviate morphine-related itching.

Nausea and Vomiting

Anti-nausea medications can help alleviate nausea associated with morphine. 5 suggests that naloxone could be an effective treatment for nausea caused by morphine.

Drowsiness

Adjusting the dosage of morphine can help manage drowsiness. If drowsiness is severe, it's essential to consult with a doctor.

Constipation

Staying hydrated, consuming a fiber-rich diet, and consulting a doctor about potential laxatives can help prevent and manage constipation related to morphine.

Respiratory Depression

Monitoring your breathing is crucial to prevent respiratory depression. Seek medical attention immediately if you notice shallow or infrequent breathing.

Comparing Studies

Similarities

These studies collectively aim to find ways to reduce the side effects of morphine. Several studies suggest the potential of drugs like naloxone, butorphanol, and nalmefene in mitigating these side effects.

Differences

These studies differ in their study populations, the type of morphine used, and the methods used to assess side effects. This makes direct comparison challenging. However, they underscore the complex nature of morphine side effects and how they can be influenced by various factors.

Applying Findings to Everyday Life

Morphine is a potent pain reliever, but it can also cause side effects. It's crucial to follow a doctor's instructions and be vigilant about any potential side effects. If you experience severe side effects, seek medical attention immediately.

Limitations of Current Research

Research on morphine side effects remains incomplete. Further investigation is needed, especially regarding long-term side effects of morphine use. Additionally, individual differences in susceptibility to morphine side effects are significant, calling for future studies that account for this variability.

Future Research Directions

More research is necessary to effectively manage morphine side effects. This includes investigating the development of new medications, refining morphine administration methods, and exploring novel approaches to minimize side effects.

Conclusion

Morphine is a valuable pain medication, but it's essential to be aware of its potential side effects. Adhering to a doctor's instructions and monitoring for any adverse reactions is crucial. If you have concerns about side effects, consult your doctor.

Literature analysis of 12 papers
Positive Content
10
Neutral Content
0
Negative Content
2
Article Type
11
1
1
1
12
1.

Epidural morphine with butorphanol in pediatric patients.

Author: LawhornC D, BrownR E

Side effect reduction

Butorphanol 40 micrograms/kg added to epidural morphine 80 micrograms/kg was found to be effective in decreasing the occurrence of side effects caused by neuraxial opioids in pediatric patients. The study involved 20 children between the ages of 2 and 17 years undergoing spinal, abdominal, or thoracic procedures.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Patient-controlled analgesia with morphine and droperidol following caesarean section under spinal anaesthesia.

Author: RussellD, DuncanL A, FrameW T, HigginsS P, AsburyA J, MillarK

Reduced nausea
Reduced vomiting
Drowsiness

Droperidol, when added to morphine for patient-controlled analgesia (PCA) after caesarean section under spinal anesthesia, reduced the incidence of nausea and emesis. However, it also caused drowsiness in two patients, which limited the usefulness of the technique.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

3.

Comparison of intravenous nalbuphine infusion versus naloxone in the prevention of epidural morphine-related side effects.

Author: WangJ J, HoS T, TzengJ I

Postoperative pain management
Nausea and vomiting
Pruritus

This study compared the efficacy of nalbuphine and naloxone intravenous infusions in preventing epidural morphine-related side effects, such as nausea, vomiting, and pruritus.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Effects of prophylactic nalmefene on the incidence of morphine-related side effects in patients receiving intravenous patient-controlled analgesia.

Author: JoshiG P, DuffyL, ChehadeJ, WesevichJ, GajrajN, JohnsonE R

Reduces opioid-related side effects

This study was designed to determine the dose-response relation for nalmefene for the prevention of morphine-related side effects in patients receiving intravenous patient-controlled analgesia.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Epidural naloxone reduces pruritus and nausea without affecting analgesia by epidural morphine in bupivacaine.

Author: ChoiJ H, LeeJ, BishopM J

Preserved analgesia
Reduced side effects
None reported

Epidural naloxone reduced morphine-induced side effects in a dose-dependent fashion without reversal of the analgesic effect.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Effect of combining naloxone and morphine for intravenous patient-controlled analgesia.

Author: SartainJames B, BarryJohn J, RichardsonChristopher A, BranaganHelen C

Reduced morphine side effects

This study investigated the effects of combining morphine and naloxone via patient-controlled analgesia (PCA) on morphine-related side effects. The combination of morphine and naloxone via PCA was found to decrease the incidence of side effects compared to morphine alone.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

7.

[Patient-controlled analgesia with lornoxicam in patients undergoing gynecological surgery].

Author: GongZ Y, YeT H, QinX T, YuG X, GuoX Y, LuoA L

Effective pain relief
Fewer adverse events

Lornoxicam provides an alternative to morphine or tramadol for the treatment of postoperative pain, with fewer adverse events.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Chinese

8.

Management of opioid side effects in cancer-related and chronic noncancer pain: a systematic review.

Author: McNicolEwan, Horowicz-MehlerNathalie, FiskRuth A, BennettKyle, Gialeli-GoudasMaria, ChewPriscilla W, LauJoseph, CarrDaniel,

Constipation
Delirium
Myoclonus
Nausea
Pruritus
Respiratory depression
Sedation
Vomiting

This systematic review assessed the management of opioid side effects in cancer pain management and chronic noncancer pain. Well-designed trials are needed to provide evidence-based guidelines for managing opioid side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

9.

Effects of epidural naloxone on pruritus induced by epidural morphine: a randomized controlled trial.

Author: JeonY, HwangJ, KangJ, HanS, RheeK, OhY

Reduced pruritus severity

Continuous epidural infusion of naloxone combined with morphine is effective in reducing the incidence and severity of pruritus induced by epidural morphine.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

10.

Cognitive-affective and somatic side effects of morphine and pentazocine: side-effect profiles in healthy adults.

Author: RileyJoseph L, HastieBarbara A, GloverToni L, FillingimRoger B, StaudRoland, CampbellClaudia M

Cognitive side effects
Somatic side effects

This study examined the subjective effects of morphine and pentazocine on somatic and cognitive/affective side effects using questionnaires.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

11.

A small-dose naloxone infusion alleviates nausea and sedation without impacting analgesia via intravenous tramadol.

Author: JiaDong-Lin, NiCheng, XuTing, ZhangLi-Ping, GuoXiang-Yang

Reduced nausea
Reduced sedation
Reduced vomiting

A small dose of naloxone infusion reduced tramadol-induced side effects without reversing its analgesic effects in patients undergoing cervical vertebrae surgery.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

12.

Does adding low doses of oral naltrexone to morphine alter the subsequent opioid requirements and side effects in trauma patients?

Author: FarahmandShervin, AhmadiOmid, DehpourAhmadreza, KhashayarPatricia

Reduced nausea

Ultra-low-dose naltrexone combined with morphine does not alter opioid requirements in patients with extremity trauma but may reduce the risk of nausea.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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