Efficacy Study of Nebulized Morphine and Intravenous Morphine in Post Traumatic Pain

Nebulized Morphine Versus Intravenous Morphine in the Management of Post Traumatic Pain in Emergency Department (ED)

In the emergency department, 60% of patients have an acute pain. Appropriate management of acute pain is a public health priority according to who recommendations. Nebulized morphine has been extensively studied in children but less well in adults.

It offers a non-invasive route for systemic drug delivery, more rapid and less invasive than intravenous (IV) method.

Inclusion Criteria:

• Post-traumatic pain with visual analog pain scale( VAPS) ≥ 50%
• Age between 8 and 50 years.

Exclusion Criteria:

• Glasgow coma scale (GCS)< 14,
• Severe injury ,
• Hypotension : blood systolic pressure < 90 mmhg,
• Bradypnea < 12 cpm or SaO2< 90%,
• Chronic pain treatment,
• Aspirin or paracetamol treatment within 6 hours of emergency presentation,
• Nasal trauma, rhinitis, nasal obstruction,
• Incapacity to cooperate,
• Opiate allergy,
• Drug addiction,
• Pregnancy, breast feeding,
• Severe renal and liver failure and chronic obstructive pulmonary disease(COPD)