Topical Morphine Gel as a Systemic Opioid Sparing Technique

Abstract

Use of topical morphine gel was explored retrospectively for treatment of painful chronic wounds in hospitalized adults. Systemic opioid use and pain intensity were characterized before and after morphine gel initiation using morphine equivalent daily dose (MEDD) and the Defense and Veterans Pain Rating Scale (DVPRS) score at 24 hours before compared to 24 hours, 48 hours, and one week after morphine gel initiation. Twenty-three patients received 371 applications of topical morphine gel. The median number of applications received was 8.0 [5.0 to 26.0] per patient. Median change in MEDD 24 hours after morphine gel initiation was 0.0 mg [−15.3 to 11.3] (n = 21), 48 hours after was −4.4 mg [−27.5 to 8.8] (n = 20), and one week after was −7.5 mg [−41.9 to −0.3] (n = 12). Median change in DVPRS score 24 hours after morphine gel initiation was 0.0 [−0.5 to 1.5] (n = 13), 48 hours after was −0.5 [−3.25 to 0.0] (n = 14), and one week after was 1.0 [−1.0 to 3.5] (n = 9). In this single-center analysis, patients with painful chronic wounds treated with morphine gel required lower doses of systemic opioids. Topical morphine gel may provide analgesia while sparing systemic opioid use.

Keywords:

• Wound
• Ulcer
• Opioid sparing
• Topical morphine

Disclosures

The authors have nothing to disclose in regards to conflicts of interest surrounding the current publication.

Data availability

Raw data were generated at The Ohio State University Wexner Medical Center. Derived data supporting the findings of this study are available from the corresponding author [MS] on request.

Additional information

Funding

The authors reported there is no funding associated with the work featured in this article.