Pain practice : the official journal of World Institute of Pain
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Comparative Study Clinical Trial
Effervescent morphine results in faster relief of breakthrough pain in patients compared to immediate release morphine sulfate tablet.
Morphine tablets have been formulated to produce an easily ingested effervescent solution when placed in water. It was hypothesized that an aqueous solution would result in fast gastrointestinal transit with a more rapid onset of action compared to immediate release morphine sulfate (IRMS), which would be especially beneficial in treating breakthrough pain (BTP). In an open-label safety and efficacy study, effervescent morphine was given to 76 chronic cancer pain patients for treatment of BTP evaluating time until pain relief, global satisfaction and side effects. ⋯ The dose for treatment of BTP was determined by individual titration and not predicted by the dose taken with the basic pain medication. Compared to IRMS, overall satisfaction for effervescent morphine was rated "superior" by 16.7%, and "better" by 63.2% of patients. Effervescent morphine offers an alternative for management of breakthrough cancer pain compared with the commonly used IRMS.
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Groin and thigh pain are frequently the major symptoms of hip joint pathology. The hip joint is innervated by articular branches of the obturator, femoral, superior gluteal, and sciatic nerves. The nerve responsible for hip joint pain can be determined by a diagnostic nerve block. ⋯ We report on two patients with groin and thigh pain related to hip joint pathology treated with a novel technique for hip pain relief, pulsed radiofrequency treatment (PRF) of articular branches of the obturator and femoral nerves. At the time this case was written, both patients demonstrated at least 50% pain relief 3 to 4 months after the intervention along with improved function (increased ambulation and ability to participate in physical therapy). Our clinical observation suggests that PRF of articular branches of the hip joint may be an alternative treatment for patients with intractable hip pain.