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Mazumdar, A., Mishra, S., Bhatnagar, S., & Gupta, D. (2008). Intravenous morphine can avoid distressing constipation associated with oral morphine: A retrospective analysis of our experience in 11 patients in the palliative care in-patient unit. American Journal of Hospice and Palliative Care, 25, 282–284.
To describe differences in bowel function with oral or IV opioids.
Intervention Characteristics/Basic Study Process
Patients who were admitted to a palliative inpatient unit for pain management had data retrospectively collected related to morphine-induced constipation. After IV morphine was administered and dose requirements were determined, patients were converted to oral morphine and then discharged.
Sample Characteristics
The study reported on a sample of 11 patients with cancer.
Mean patient age was 43 years.
The sample comprised eight men and three women.
Patients were included in the study if they were admitted to a palliative care unit for IV morphine.
Patients were excluded if they had gastrointestinal malignancy or disorders.
Setting
Single site
Inpatient
India
Phase of Care and Clinical Applications
The study has clinical applicability to end-of-life and palliative care.
Study Design
This was a retrospective, descriptive study.
Measurement Instruments/Methods
Visual analog scale
Results
Patients on IV morphine did not require laxatives for bowel movements to occur.
Of patients switched to oral morphine, seven of 11 needed laxatives during their inpatient stay and were discharged with laxative prescriptions.
Conclusions
Patients on IV morphine were less likely to need laxative therapy to promote bowel function compared with patients on oral morphine. All patients on oral morphine needed laxative therapy.
Limitations
The sample size was extremely small.
The design was retrospective and descriptive only.
Nursing Implications
Implications are limited because of the small sample size and other uncontrolled variables. More research is needed to determine whether IV morphine is less constipating than oral morphine and the applicability of this information in patient care.