A randomized, controlled, clinical pilot study assessing the analgesic effect of morphine applied topically onto split-thickness skin wounds. (19th June 2014)

• Record Type: Journal Article
• Authors: Zaslansky, Ruth; Ben-Nun, Ohad; Ben-Shitrit, Sima; Ullmann, Yehuda; Kopf, Andreas; Stein, Christoph
• Is Part Of: Journal of pharmacy and pharmacology. Volume 66:Number 11(2014:Nov.)
• Page Start: 1559
• Page End: 1566
• Publication Date: 2014-06-19
• Subjects: morphine -- pain -- split thickness skin graft -- topical application; Pharmacy -- Periodicals; Pharmacology -- Periodicals; 615.1
• DOI: 10.1111/jphp.12284
• Languages: English
• ISSNs: 0022-3573

Abstract

Abstract: Objectives: To assess the effect of an opioid administered topically onto a standardized skin wound in patients without significant comorbidity. Findings to date are contradictory, often obtained from multimorbid patients with wounds lacking uniformity. Methods: Forty-four patients undergoing surgery for skin grafting were randomly assigned to receive morphine (0.25, 0.75 or 1.25 mg/100 cm 2 wound size) in hydroxyethylcellulose gel or placebo applied onto the excised split-thickness donor wound at the end of surgery. Pain, supplementary systemic opioids and adverse effects were assessed during the first 24 h after application. Healing was examined when the dressings were removed. Key findings: Morphine doses ranged from 0.25 to 5.4 mg (mean 1.93 ± standard deviation 1.34 mg). No differences in pain scores or use of supplementary analgesics were found between the groups. Serious adverse effects did not occur; healing was not impaired. Large intragroup variability was observed for pain scores, wound sizes and supplementary analgesia. Conclusions: Patients treated with topically applied morphine gel onto standardized skin wounds did not report lower pain scores compared with placebo-treated patients. Larger groups would be required to arrive at definitive conclusions. The split-thickness skin graft model can be used for future research.