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Forty-eight hours of postoperative pain relief after total hip arthroplasty with a novel, extended-release epidural morphine formulation.

Publication ,  Journal Article
Viscusi, ER; Martin, G; Hartrick, CT; Singla, N; Manvelian, G; EREM Study Group,
Published in: Anesthesiology
May 2005

BACKGROUND: Epidural morphine has proven analgesic efficacy in the postoperative period and is widely used. This study evaluated the efficacy of extended-release epidural morphine (EREM; DepoDur; Endo Pharmaceuticals Inc., Chadds Ford, PA; SkyePharma, Inc., San Diego, CA) in providing pain relief for 48 h after surgery. METHODS: Patients (n = 200) scheduled to undergo total hip arthroplasty were randomized to receive a single dose of 15, 20, or 25 mg EREM or placebo. After surgery and after asking for pain medication, patients had access to intravenous patient-controlled analgesia fentanyl for breakthrough pain as needed. Postoperative intravenous patient-controlled analgesia fentanyl use, time to first postoperative fentanyl use, pain intensity at rest and with activity, patient and surgeon ratings of pain control, and adverse events were recorded. RESULTS: All EREM dosages reduced the mean (+/- SD) fentanyl use versus placebo (510 +/- 708 vs. 2,091 +/- 1,803 microg; P < 0.0001) and delayed the median time to first dose of fentanyl (21.3 vs. 3.6 h; P < 0.0001). All EREM groups had significantly improved pain control at rest through 48 h postdose (area under the curve [0-48 h]) compared with placebo (P < 0.0005). More EREM-treated patients rated their pain control as good or very good compared with placebo (at 24 h: 90 vs. 65%, P < 0.0001; at 48 h: 83 vs. 67%, P < 0.05). No supplemental analgesia was needed in 25% of EREM-treated patients and 2% of placebo-treated patients at 48 h (P < 0.05). The safety profile of EREM was consistent with that of other epidurally administered opioid analgesics. CONCLUSIONS: EREM provided significant postoperative pain relief over a 48-h period after hip surgery, without the need for indwelling epidural catheters.

Duke Scholars

Published In

Anesthesiology

DOI

ISSN

0003-3022

Publication Date

May 2005

Volume

102

Issue

5

Start / End Page

1014 / 1022

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Pain, Postoperative
  • Morphine
  • Middle Aged
  • Male
  • Liposomes
  • Humans
  • Fentanyl
  • Female
  • Double-Blind Method
 

Citation

APA
Chicago
ICMJE
MLA
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Viscusi, E. R., Martin, G., Hartrick, C. T., Singla, N., Manvelian, G., & EREM Study Group, . (2005). Forty-eight hours of postoperative pain relief after total hip arthroplasty with a novel, extended-release epidural morphine formulation. Anesthesiology, 102(5), 1014–1022. https://doi.org/10.1097/00000542-200505000-00022
Viscusi, Eugene R., Gavin Martin, Craig T. Hartrick, Neil Singla, Garen Manvelian, and Garen EREM Study Group. “Forty-eight hours of postoperative pain relief after total hip arthroplasty with a novel, extended-release epidural morphine formulation.Anesthesiology 102, no. 5 (May 2005): 1014–22. https://doi.org/10.1097/00000542-200505000-00022.
Viscusi ER, Martin G, Hartrick CT, Singla N, Manvelian G, EREM Study Group. Forty-eight hours of postoperative pain relief after total hip arthroplasty with a novel, extended-release epidural morphine formulation. Anesthesiology. 2005 May;102(5):1014–22.
Viscusi, Eugene R., et al. “Forty-eight hours of postoperative pain relief after total hip arthroplasty with a novel, extended-release epidural morphine formulation.Anesthesiology, vol. 102, no. 5, May 2005, pp. 1014–22. Pubmed, doi:10.1097/00000542-200505000-00022.
Viscusi ER, Martin G, Hartrick CT, Singla N, Manvelian G, EREM Study Group. Forty-eight hours of postoperative pain relief after total hip arthroplasty with a novel, extended-release epidural morphine formulation. Anesthesiology. 2005 May;102(5):1014–1022.

Published In

Anesthesiology

DOI

ISSN

0003-3022

Publication Date

May 2005

Volume

102

Issue

5

Start / End Page

1014 / 1022

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Pain, Postoperative
  • Morphine
  • Middle Aged
  • Male
  • Liposomes
  • Humans
  • Fentanyl
  • Female
  • Double-Blind Method