Nurse-administered subcutaneous morphine is a satisfactory alternative to intravenous patient-controlled analgesia morphine after cardiac surgery

There are no comparisons of TV patient controlled analgesia (TV PCA) versus nurse-administered subcutaneous (NA SC) morphine for acute postoperative pain. We undertook a prospective, randomized, controlled clinical trial of 80 cardiac surgical patients to compare IV PCA with NA SC morphine for postoperative pain control. Visual analog scale (VAS) pain scores at rest and with movement, daily verbal pain relief scores, and side effect profiles were not significantly different. Total morphine requirements in the two groups were not significantly different. A physiotherapist's evaluation of the effectiveness of analgesia for chest physiotherapy revealed no difference between the two groups. We conclude that NA SC morphine, administered as required (up to hourly), is a satisfactory alternative to TV PCA morphine after cardiac surgery. Implications: In a prospective, randomized study, we have shown that nurse-administered subcutaneous morphine is a satisfactory alternative to IV patient-controlled analgesia after cardiac surgery.