A comparison of subcutaneous morphine
and fentanyl in hospice cancer patients
Hunt R, Fazekas B, Thorne D, Brooksbank M.
Southern Community Hospice Programme,
Daw House Hospice, SA, Australia.
J Pain Symptom Manage 1999 Aug;18(2):111-9
This study compares subcutaneous (s.c.) morphine and fentanyl with respect to pain control and side effects using a 6-day randomized, double-blind, cross-over design. Results were obtained from 23 patients (12 males and 11 females: mean age of 70.5 years) who could tolerate morphine. Thirteen patients were randomized to receive morphine for the first 3 days followed by fentanyl; 10 received fentanyl first followed by morphine. There were no significant differences in the scores for pain between the two drugs, suggesting that fentanyl is equally efficacious and the conversion ratio of morphine 10 mg: fentanyl 150 micrograms is appropriate. Patients had more frequent bowel movements during days 4-6 while on the fentanyl arm [t-test, df (22), P = 0.015]. Other measures for nausea, delirium, and cognitive function showed no differences between the two drugs. This study highlights the need to further assess the role of various opioids in hospice patients, and emphasizes the requirement for sensitive and simple cognitive tests in this population.
Fentanyl and ketamine
Is morphine a smart drug?
Opioids, mood and cognition
Is morphine an antidepressant?
Depression, opioids and the HPA
Methadone, morphine and heroin
Morphine and life-expectancy in the hospice
and further reading
The Abolitionist Project
The Hedonistic Imperative
The Reproductive Revolution
Critique of Huxley's Brave New World
The Good Drug Guide
The Responsible Parent's Guide
To Healthy Mood Boosters For All The Family