Topical morphine gel in the treatment of painful leg ulcers, a double-blind, placebo-controlled clinical trial: a pilot study.

Abstract

Chronic painful wounds, a major health problem, have a detrimental impact on the quality of life due to associated pain. Some clinical reports have suggested that local administration of morphine could be beneficial. The aim of this study was to evaluate the analgesic effect of topically applied morphine on chronic painful leg ulcers. Twenty-one patients were randomly assigned to receive either morphine or placebo in a randomised, placebo-controlled, crossover pilot study. Each patient was treated four times in total. Pain was measured by the visual analogue score (VAS) before application of gel, directly after and after 2, 6, 12 and 24 hours. Although an overall, clinically relevant, reduction of pain was observed upon treatment with morphine, the difference was not statistically significant. Morphine reduced pain scores more than placebo on treatment occasions 1 and 2. The difference was statistically significant only 2 hours after dressing on the first treatment occasion. Thus, our study did not demonstrate a consistent and globally significant difference in nociception in patients treated with morphine. However, the relatively small number of patients included in our study and other methodological limitations makes it difficult for us to draw general conclusions regarding efficacy of topically applied morphine as an effective treatment for some painful ulcers. Further studies are warranted to evaluate the value of topically applied morphine in the treatment of patients with chronic painful leg ulcers.

• Authors: Salumeh Bastami, Thomas Frödin, Johan Ahlner, Srinivas Uppugunduri
• Journal: International wound journal (Int Wound J) Vol. 9 Issue 4 Pg. 419-27 (Aug 2012) ISSN: 1742-481X [Electronic] England
• PMID: 22151619 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © 2011 The Authors. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

Chemical References

• Gels
• Morphine

Topics

• Administration, Cutaneous
• Aged
• Aged, 80 and over
• Analysis of Variance
• Chronic Disease
• Chronic Pain (diagnosis, drug therapy)
• Cross-Over Studies
• Dose-Response Relationship, Drug
• Double-Blind Method
• Drug Administration Schedule
• Female
• Follow-Up Studies
• Gels (therapeutic use)
• Humans
• Leg Ulcer (diagnosis, drug therapy)
• Male
• Middle Aged
• Morphine (therapeutic use)
• Pain Measurement (drug effects)
• Pilot Projects
• Reference Values
• Severity of Illness Index
• Time Factors
• Treatment Outcome
• Wound Healing (drug effects, physiology)