Comparing the Effect of Intranasal Morphine and Intravenous Morphine in Upper Limb Orthopedic Surgeries

Pain control is a major issue after surgery and the most widely used drug is morphine. There are several methods for administration of morphine. The present investigation aimed at comparing the effect of intranasal morphine and intravenous morphine on orthopedic surgery in upper limb.

In this clinical trial, 86 patients were randomly divided into two groups to receive either intranasal morphine (n=43) or intravenous morphine (n=43). Pain intensity was measured using Numerical Rating Scale (NRS) and Visual Analogue Scale (VAS). Pain, nausea, vomiting, pruritus, restlessness, confusion, hemodynamic status, and SPO2 at 10, 30, 60 minutes and 2 and 4 hours after receiving morphine were recorded. Data were analyzed in SPSS V22 applying t-test, Mann-Whitney, Fisher's exact test, and Chi-square.

There were 19.8% (n=17) female and 80.2% (n=69) male patients. There were no significant differences in demographic characteristics between the participants (P>0.05). Mean postoperative pain was significantly lower in patients that received intravenous morphine (2.19) compared to those in intranasal morphine group (3.76). The two groups were found to be significantly different in postoperative pain, hemodynamic status, respiration, and SPO2 (P<0.05). Postoperative nausea and vomiting, pruritus, restlessness, and dizziness were reported to be similar between the two groups (P>0.05).

The study showed that both intranasal morphine and intravenous morphine reduced postoperative pain and caused minimal complications, but intravenous morphine is more effective due to faster entry and absorption into the blood.