Astramorph (Morphine Sulfate Epidural) - Summary

ASTRAMORPH SUMMARY

ASTRAMORPH/PF™
(morphine sulfate injection, USP) Preservative-Free CS-ll

Morphine is the most important alkaloid of opium and is a phenanthrene derivative.

ASTRAMORPH (Morphine EPIDURAL) is indicated for the following:

Astramorph/PF is a systemic narcotic analgesic for administration by the intravenous, epidural or intrathecal routes. It is used for the management of pain not responsive to non-narcotic analgesics. Astramorph/PF, administered epidurally or intrathecally, provides pain relief for extended periods without attendant loss of motor, sensory or sympathetic function.

See all Astramorph indications & dosage >>

NEWS HIGHLIGHTS

Media Articles Related to Astramorph (Morphine Epidural)

The Opioid Crisis and Need for Compassion in Pain Management
Source: Medscape Anesthesiology Headlines [2017.09.28]
In this commentary, the author expresses concern that the response to the public health crisis of opioid addiction is creating a growing crisis of inadequate pain management.
American Journal of Public Health

CVS to Restrict Opioid Painkiller Prescription Amounts
Source: MedicineNet Drug Abuse Specialty [2017.09.25]
Title: CVS to Restrict Opioid Painkiller Prescription Amounts
Category: Health News
Created: 9/22/2017 12:00:00 AM
Last Editorial Review: 9/25/2017 12:00:00 AM

Stomach Pain Quiz: Nausea & Other Causes
Source: MedicineNet Anal Fissure Specialty [2017.09.19]
Title: Stomach Pain Quiz: Nausea & Other Causes
Category: MedicineNet Quiz
Created: 1/20/2011 12:00:00 AM
Last Editorial Review: 9/19/2017 5:59:56 PM

Back Pain Quiz: Test Your Back Pain IQ
Source: MedicineNet Ankylosing Spondylitis Specialty [2017.09.19]
Title: Back Pain Quiz: Test Your Back Pain IQ
Category: MedicineNet Quiz
Created: 6/16/2011 3:41:00 PM
Last Editorial Review: 9/19/2017 6:39:04 PM

Pain Quiz: Test Your IQ of Pain
Source: MedicineNet Constipation Specialty [2017.09.19]
Title: Pain Quiz: Test Your IQ of Pain
Category: MedicineNet Quiz
Created: 7/14/2011 3:53:00 PM
Last Editorial Review: 9/19/2017 6:41:41 PM

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Published Studies Related to Astramorph (Morphine Epidural)

Evaluation of a single-dose, extended-release epidural morphine formulation for pain control after lumbar spine surgery. [2014]
DepoDur, an extended-release epidural morphine, has been used effectively for postoperative pain control following many orthopaedic and general surgery procedures and has provided prolonged analgesia when compared with Duramorph. The goal of this article was to compare the safety and analgesic efficacy of DepoDur versus Duramorph after lumbar spine surgery...

Transversus abdominis plane block versus perioperative intravenous lidocaine versus patient-controlled intravenous morphine for postoperative pain control after laparoscopic colorectal surgery: study protocol for a prospective, randomized, double-blind controlled clinical trial. [2014]
BACKGROUND: Despite the laparoscopic approach becoming the standard in colorectal surgery, postoperative pain management for minimally invasive surgery is still mainly based on strategies that have been established for open surgical procedures... DISCUSSION: Recognizing the importance of a multimodal approach for perioperative pain management, we aim to investigate whether a transversus abdominis plane block delivers superior pain control in comparison to perioperative intravenous lidocaine and patient-controlled intravenous analgesia with morphine alone.

Transversus abdominis plane block reduces morphine consumption in the early postoperative period following microsurgical abdominal tissue breast reconstruction: a double-blind, placebo-controlled, randomized trial. [2014]
in a randomized controlled trial... CONCLUSION: Following abdominally based breast reconstruction, transversus

Ropivacaine Continuous Wound Infusion Versus Epidural Morphine for Postoperative Analgesia After Cesarean Delivery: A Randomized Controlled Trial. [2011.10.24]
Background:The infusion of local anesthetic in the surgical wound is helpful in the multimodal management of postoperative pain. We hypothesized that local anesthetic wound infusion after cesarean delivery would provide better pain control than epidural morphine analgesia.Methods:Healthy, term women scheduled for elective cesarean delivery were included in this assessor-blinded, randomized study...

Prior epidural lidocaine alters the pharmacokinetics and drug effects of extended-release epidural morphine (DepoDur(R)) after cesarean delivery. [2011.08]
BACKGROUND: A potential physicochemical interaction between epidural local anesthetics and extended-release epidural morphine (EREM) could negate the sustained release. In this study, we sought to determine the pharmacokinetic and drug effects of prior epidural lidocaine administration on EREM... CONCLUSION: A large dose of epidural lidocaine 1 hour before EREM administration alters the pharmacokinetics and drug effects of EREM. Clinicians must apply caution when EREM is administered even 1 hour after an epidural lidocaine "top-up" for cesarean delivery.

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Clinical Trials Related to Astramorph (Morphine Epidural)

Patients-Controlled Epidural Analgesia After Gastric Bypass for Morbid Obesity Using Morphine-Levobupivacaine Regimens [Completed]
Adequate postoperative analgesia can facilitate recovery following gastric bypass surgery

for morbid obesity. The efficacy and safety of intravenous patient - controlled analgesia

has been studied, but up to date no data are available concerning the use of thoracic epidural patient-controlled analgesia regarding the use of levobupivacaine combined with morphine in morbidly obese patients. The investigators' aim in this prospective, randomized, double-blinded study was to compare the analgesic effectiveness, the dose requirements and side effects of thoracic epidural patient controlled analgesia 0. 1% and 0. 2% levobupivacaine combined with a continuous epidural administration of morphine, with or without a loading dose, after open gastric bypass for morbid obesity.

The Median Effective Dose (ED50) of Paracetamol and Morphine : A Study of Interaction Study [Completed]
The aim of our study is to define the median effective analgesic doses (ED50) of paracetamol, morphine, and their combination and determination the nature of their interaction administered IV for postoperative pain after moderate painful surgery using up-and-down and isobolographic methods.

A Comparison of Morphine and Morphine Plus Dexmedetomidine in Chronic Cancer Pain [Recruiting]
The purpose of this study is to determine whether dexmedetomidine added to morphine is effective in the treatment of chronic cancer pain.

Ketamine Associated With Morphine PCA After Total Hip Arthroplasty [Completed]
Ketamine (an analgesic drug often associated with morphine in the treatment of Opioid Induced Hyperalgesia) is often mixed in Morphine PCA syringe. We make the hypothesis that ketamine administrated separately via a continuous infusion, could induced a better analgesic effect. We will perform a randomised double blind study to determine the best infusion mode of intravenous ketamine, associated with morphine in PCA syringe or alone in continuous infusion.

Continuous Pre-uterine Wound Infiltration Versus Intrathecal Morphine for Postoperative Analgesia After Cesarean Section [Recruiting]
The cesarean section is considered as a painful surgery during the post operative period. Mothers may need to move immediately after the surgery to take care of their babies. This may increase the risk of major pain and chronic pain. Thus, excellent postoperative analgesia is required so that mothers do not experience pain in caring for their baby. Currently, several techniques have been developed to manage postoperative pain related to c-section scar such as intrathecal morphine during spinal anesthesia or continuous pre-peritoneal wound infiltration. The comparison between anesthetic techniques has never been performed and it is still not know if the combination of intrathecal morphine plus continuous pre-peritoneal wound infiltration provide a synergistic or additional effect on pain relief.

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