Comparaison prospective et randomisée de la morphine nébulisée versus la péridurale thoracique dans la prise en charge de la douleur des traumatisés thoraciques

Inhaled opioids for cancer pain relief

“…The analgesic effect, where the primary endpoint was to obtain a pain VAS score of less than 4, was similar in both treatment arms, as well as sedation. [ 23 ] In a prospective, uncontrolled study performed by Bounes et al, a single dose of 0.2 mg/kg nebulized morphine was unable to provide satisfactory analgesia, that is, a pain numeric rating scale (NRS) of 30/100 or lower. [ 24 ] The study group consisted of 28 patients treated in the ED with severe acute pain that was 60 mm or higher.…”

“…Nonetheless, sedation scores were higher in the intravenous morphine group (modified Ramsay sedation scale [RSS]: 0.33 vs 0.56) [22] . No side effects of nebulized morphine, apart from minor sedation ranked 1 in RSS, were recorded in a prospective trial in thoracic trauma patients, conducted by Nejmi et al [23] The authors randomized 40 patients to receive either repeated doses of 8 mg nebulized morphine or epidural bupivacaine for 48 hours. The analgesic effect, where the primary endpoint was to obtain a pain VAS score of less than 4, was similar in both treatment arms, as well as sedation [23] .…”

“…No side effects of nebulized morphine, apart from minor sedation ranked 1 in RSS, were recorded in a prospective trial in thoracic trauma patients, conducted by Nejmi et al [23] The authors randomized 40 patients to receive either repeated doses of 8 mg nebulized morphine or epidural bupivacaine for 48 hours. The analgesic effect, where the primary endpoint was to obtain a pain VAS score of less than 4, was similar in both treatment arms, as well as sedation [23] . In a prospective, uncontrolled study performed by Bounes et al, a single dose of 0.2 mg/kg nebulized morphine was unable to provide satisfactory analgesia, that is, a pain numeric rating scale (NRS) of 30/100 or lower [24] .…”