An anesthesiologist Raymond Sinatra says: “Lowering morphine consumption reduces postsurgical complications and helps patients recover quicker. That translates into shorter hospital stays, healthier patients, and reduced health care costs.”

On the one hand morphine relieves pain, but on the other hand it may cause unwanted side effects such as nausea, vomiting, constipation, drowsiness, and a slowdown in breathing. That is why anesthesiology research concentrates on looking for alternative drugs that can reduce or eliminate the need for morphine.

It can be achieved thanks to a new soluble form of acetaminophen delivered by a catheter into a vein. This drug reduced morphine intake by more than 30% in patients studied following major hip or knee surgery who were able to give themselves the narcotic by means of a patient-controlled analgesia pump. It is expected that the medication will be approved soon by U.S. Food and Drug Administration.

Sinatra says that the injectable form of acetaminophen reaches the central nervous system sooner and in a higher concentration than in standard tablet form. This is how it enhances the drug’s analgesic power. It is a wonderful method of dealing with pain in orthopedic patients (suitable healing following many types of orthopedic surgeries relies on an inflammatory process helping build new bone). Injectable acetaminophen is not an anti-inflammatory drug and this is why it does not interfere with this healing process.

A second Yale research discovered the safety and effectiveness of a COX-2 inhibitor, rofecoxib, as a surgical pain reliever. The study zeroed in on the medication’s ability to decrease pain and ameliorate the ability of patients to cough after abdominal surgery as well as its role in diminishing morphine intake. COX-2 inhibitors act by selectively switching off one of the cylooxygenase (COX) enzymes that is in charge of the production of prostaglandins.

Surgical cut in the abdominal area usually make a 30-40% decrease in normal breathing patterns, especially in patients receiving morphine after surgery. The patients who got a single 50-mg dose of rofecoxib syrup before surgery had just a 15% decline in lung function after surgery, compared to 35-40% for the placebo group. What’s more, the rofecoxib group consumed 44% less morphine than the control group within the first 24 hours after surgery.

According to Sinatra, “While we won’t eliminate the need for morphine in the near future, administration of safe non-narcotic analgesics can minimize its use while at the same time improving Pain relief.

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