Comparing Side Effects Related to Method of Morphine Administration in Post Operative Orthopedic and Spine Surgery Patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/182843
Category:
Abstract
Type:
Presentation
Title:
Comparing Side Effects Related to Method of Morphine Administration in Post Operative Orthopedic and Spine Surgery Patients
Author(s):
Lambert, Teresa; Pearson, Bethany
Author Details:
Teresa Lambert, RN, CNRN, Flagler Hospital, Saint Augustine, Florida, USA, email: teresa.lambert@flaglerhospital.org; Bethany Pearson, RN
Abstract:
Poster Presentation: PURPOSE: This retrospective, corelational study examined the side effects of both lipposomal epidural injected morphine (Depodur) and patient controlled intravenous administration (PCA) morphine on post operative orthopaedic and spine surgery patients. METHOD: Study setting is a 43-bed surgical unit in Northeast Florida. All orthopaedic Depodur patients were reviewed post discharge and compared with a random sample of orthopaedic Morphine PCA patients. Data was collected from patient charts that received Depodur and PCA morphine as a primary means of post operative pain control. Blood pressure pre-procedure; all fluid volume intake and out put from operating room to discharge and the patient's self reported pain scales were extracted for study purposes. FINDINGS: Both morphine administration methods produced significant hypotension and significant urine retention. Forty-four percent of the Depodur patients had a hypotensive episode with an average systolic blood pressure drop of 39 points and ninety-nine percent had an average fluid retention of 4.3 liters. Sixteen percent of Depodur patients reported severe pain. Morphine PCA also caused 37 percent of the patients to have an average systolic blood pressure drop of 34 points with seventy-eight percent having an average of 3.3 liters fluid retained. Fifty-four percent of these patients reported severe pain. DISCUSSION: The data demonstrates that both pain control modalities cause significant hypotension and fluid volume retention. However, Depodur provided superior pain control with little breakthrough pain. While the choice of which pain relief modality is ultimately the choice the anesthesiologist; nurses can post operatively manage the negative side effects. The study findings were utilized in the formulation of nursing driven order sets that address and minimize. [Please contact presenter for more information.] Buggy, D., Power, C., Meeke, R., O'Callaghan, S., Moran, C., & O'Brien, G. (1998). Prevention of spinal anesthesia-induced hypotension in the elderly: i.m. methoxamine or combined hetastarch and crystalloid. British Journal of Anesthesia, 80, 199-203. Habib, A., Chen, Y., Taguchi, A., Hu, X., & Gan, T. (2006). Postoperative nausea and vomiting following inpatient surgeries in a teaching hospital: a retrospective database analysis. Health & Medical Compete, 22, 6, 1093-1099. Pandey, C., Priye, S., Ambesh, S., Singh, S., Singh, U., & Singh, P. (2006). Prophylactic gabapentin for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy: A randomized, double-blind, placebo-controlled study. Journal of Postgraduate Medicine, 52, 2, 97-99. Singelyn, F., Ferrant, T., Malisse, M., & Joris, D. (2005). Effects of intravenous patient-controlled analgesia with morphine, continuous epidural analgesia, and continuous femoral nerve sheath block on rehabilitation after unilateral total hip arthoplasty. Regional Anesthesia and Pain Medicine, 30, 5, 452-457.
Repository Posting Date:
28-Oct-2011
Date of Publication:
28-Oct-2011
Conference Date:
2007
Conference Name:
ANCC National Magnet Conference
Conference Host:
American Nurses Credentialing Center
Conference Location:
Atlanta, Georgia, USA
Description:
"Connect, Empower and Celebrate" was the theme of the 11th American Nurses Credentialing Center (ANCC) National Magnet Conference, held 3-5 October, 2007 at the Georgia World Congress Center in Atlanta, Georgia, USA.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleComparing Side Effects Related to Method of Morphine Administration in Post Operative Orthopedic and Spine Surgery Patientsen_GB
dc.contributor.authorLambert, Teresaen_US
dc.contributor.authorPearson, Bethanyen_US
dc.author.detailsTeresa Lambert, RN, CNRN, Flagler Hospital, Saint Augustine, Florida, USA, email: teresa.lambert@flaglerhospital.org; Bethany Pearson, RNen_US
dc.identifier.urihttp://hdl.handle.net/10755/182843-
dc.description.abstractPoster Presentation: PURPOSE: This retrospective, corelational study examined the side effects of both lipposomal epidural injected morphine (Depodur) and patient controlled intravenous administration (PCA) morphine on post operative orthopaedic and spine surgery patients. METHOD: Study setting is a 43-bed surgical unit in Northeast Florida. All orthopaedic Depodur patients were reviewed post discharge and compared with a random sample of orthopaedic Morphine PCA patients. Data was collected from patient charts that received Depodur and PCA morphine as a primary means of post operative pain control. Blood pressure pre-procedure; all fluid volume intake and out put from operating room to discharge and the patient's self reported pain scales were extracted for study purposes. FINDINGS: Both morphine administration methods produced significant hypotension and significant urine retention. Forty-four percent of the Depodur patients had a hypotensive episode with an average systolic blood pressure drop of 39 points and ninety-nine percent had an average fluid retention of 4.3 liters. Sixteen percent of Depodur patients reported severe pain. Morphine PCA also caused 37 percent of the patients to have an average systolic blood pressure drop of 34 points with seventy-eight percent having an average of 3.3 liters fluid retained. Fifty-four percent of these patients reported severe pain. DISCUSSION: The data demonstrates that both pain control modalities cause significant hypotension and fluid volume retention. However, Depodur provided superior pain control with little breakthrough pain. While the choice of which pain relief modality is ultimately the choice the anesthesiologist; nurses can post operatively manage the negative side effects. The study findings were utilized in the formulation of nursing driven order sets that address and minimize. [Please contact presenter for more information.] Buggy, D., Power, C., Meeke, R., O'Callaghan, S., Moran, C., & O'Brien, G. (1998). Prevention of spinal anesthesia-induced hypotension in the elderly: i.m. methoxamine or combined hetastarch and crystalloid. British Journal of Anesthesia, 80, 199-203. Habib, A., Chen, Y., Taguchi, A., Hu, X., & Gan, T. (2006). Postoperative nausea and vomiting following inpatient surgeries in a teaching hospital: a retrospective database analysis. Health & Medical Compete, 22, 6, 1093-1099. Pandey, C., Priye, S., Ambesh, S., Singh, S., Singh, U., & Singh, P. (2006). Prophylactic gabapentin for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy: A randomized, double-blind, placebo-controlled study. Journal of Postgraduate Medicine, 52, 2, 97-99. Singelyn, F., Ferrant, T., Malisse, M., & Joris, D. (2005). Effects of intravenous patient-controlled analgesia with morphine, continuous epidural analgesia, and continuous femoral nerve sheath block on rehabilitation after unilateral total hip arthoplasty. Regional Anesthesia and Pain Medicine, 30, 5, 452-457.en_GB
dc.date.available2011-10-28T15:42:35Z-
dc.date.issued2011-10-28en_GB
dc.date.accessioned2011-10-28T15:42:35Z-
dc.conference.date2007en_US
dc.conference.nameANCC National Magnet Conferenceen_US
dc.conference.hostAmerican Nurses Credentialing Centeren_US
dc.conference.locationAtlanta, Georgia, USAen_US
dc.description"Connect, Empower and Celebrate" was the theme of the 11th American Nurses Credentialing Center (ANCC) National Magnet Conference, held 3-5 October, 2007 at the Georgia World Congress Center in Atlanta, Georgia, USA.en_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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