Dosage of Epidural Morphine in Elderly Patients

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    Assiut University
Updated on 24 January 2021
cancer surgery


This a clinical trial that evaluates the efficacy and safety of three different doses of morphine, namely 1.5 mg, 3 mg and 4.5 mg, via the epidural route regarding reducing pain in elderly patients after a cancer surgery in the lower abdomen


Acute postoperative pain is a common complaint for several days after surgery. However, acute postoperative pain remains even more under controlled in elderly patients, especially those with cognitive impairment and malignancy. Geriatric population is reported to be at higher risk for unwanted side effects from analgesic treatments compared to younger patients due to different major risk factors such as: decline in organ function, polypharmacy, pharmacokinetics, drug sensitivity, and frailty. Despite of the higher risk of opioids, especially morphine, causing toxicity and adverse effect; they are still the cornerstone treatment of severe acute postoperative pain. Morphine in those patients is very likely to cause toxicity because of accumulation of its active metabolites compared to other opioids with fewer or no active metabolites. Epidural morphine is an effective route for an effective drug. Furthermore, unwanted side effects with neuraxial opioids are minor and managed easily. Regarding clinical outcomes, clinical studies showed a lot of improvements associated with postoperative opioid analgesia. Now, there is a clinical necessity to achieve the best management of acute postoperative pain in elderly patients with the least possibility of adverse side effects. We aim in this randomized, assessor blinded, clinical trial at Assuit University to determine the optimum dose of epidural morphine for the highest control of acute postoperative pain in geriatrics who are planned to have lower abdominal cancer surgery.

Condition Abdominal Cancer, Age Problem
Treatment Normal saline, morphine sulfate
Clinical Study IdentifierNCT04316871
SponsorAssiut University
Last Modified on24 January 2021


Yes No Not Sure

Inclusion Criteria

Is your age greater than or equal to 65 yrs?
Gender: Male or Female
Do you have any of these conditions: Abdominal Cancer or Age Problem?
Do you have any of these conditions: Age Problem or Abdominal Cancer?
Men and women aged 60 years, who are planned to undergo lower abdominal cancer surgery
Surgeries via infra-umbilical abdominal incision is considered eligible

Exclusion Criteria

Patient refusal
Patients who are morbidly obese (body mass index 40 kg/m2)
Those with contraindications to neuraxial analgesia
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