Epidural morphine availability

Hydromorphone is a semisynthetic opioid agonist prescribed for control of moderate to severe pain. It was first synthesized in 1924 and introduced by Knoll pharmaceuticals under the brand name Dilaudid . Intravenous hydromorphone is about 5-6 times more potent than morphine however, when administered epidurally, morphine provides greater spinal selectivity and 2-3 times greater analgesic potency than hydromorphone. Hydromophone is available as a... 

Sufentanil, fentanyl, remifentanil, alfentanil, and morphine sulfate should be administered only by those specifically trained in the use of IV and epidural anesthetics Oxygen, resusdtative, and intubation equipment should be readily available. 

Morphine is often the choice in this category (1) multiple products available (2) multiple route of administration options, such as oral, rectal. IM. SC. IV. epidural, and intrathecal and (3) a known eqiipotency between these routes that allows a much easier transition. 

Dosages and routes of administration Morphine is available in different salt forms but the hydrochloride and sulfate (Vermeire and Remon, 1999) are used preferentially. The compound can be administered by the oral, parenteral or intraspinal route. Oral application is preferred for chronic pain treatment and various slow release forms have been developed to reduce the administration frequency to 2-3 times per day (Bourke et al., 2000). Parenteral morphine is used in intravenous or intramuscular doses of 10 mg, mostly for postoperative pain and self-administration devices are available for patient-controlled analgesia (PCA). Morphine is additionally used for intraspinal (epidural or intrathecal) administration. Morphine is absorbed reasonably well in the lower gastrointestinal tract and can be given as suppositories. 

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