[Nurse Hatchett]

Has anyone heard of this, we just started using it on our Hospice pts, and I think it is a wonderful creation. Perfect fo the end of the life, when PO meds can't be given, and sure beats shots etc. Of cours I may just be behind the times and it may not be new to many of you. I was just real excited about it.........Amazing what excites us nurses

[madwife2002]

No never heard of it but would be interested to know more about it please. Always keen to know about new things, it may be like you it is already being utilised around UK, but I know nothing.

[txspadequeen921]

I have used alot of things in gels,morphine, phenergan, ativan, haldol,benadryl plus more that is escaping my worn out mind now. The gels are great for end of life paitents however, sometimes it does not cover as well as the pills or injections do. I bet you would find you would be using your roxanol more if you used the gel. However, it is a wonderful concept and the dosage of the gel could be increased , and probably it would work just fine.

[Nurse Hatchett]

Originally Posted by madwife2002

No never heard of it but would be interested to know more about it please. Always keen to know about new things, it may be like you it is already being utilised around UK, but I know nothing.

It comes in prefilled syringes and we just apply it to a hairless area, like wrist, and rub it in. It is supposed to be fairly fast acting too. As also posted these gels come in other drugs also. As far as using more often, I have no idea, as I haven't but a itty bit of experience with them

[madwife2002]

Originally Posted by Nurse Hatchett

It comes in prefilled syringes and we just apply it to a hairless area, like wrist, and rub it in. It is supposed to be fairly fast acting too. As also posted these gels come in other drugs also. As far as using more often, I have no idea, as I haven't but a itty bit of experience with them

Thanks will look out for it and discuss it round work

[hypnotic_nurse]

Teresa Long, MD, KUMC did some studies with morphine gel and pressure ulcers; I believe those results have been published. I was lucky enough to work with her on several studies, and the gel really did seem to help quite a bit. The pts wound up taking less oral pain meds.

[madwife2002]

Originally Posted by hypnotic_nurse

Teresa Long, MD, KUMC did some studies with morphine gel and pressure ulcers; I believe those results have been published. I was lucky enough to work with her on several studies, and the gel really did seem to help quite a bit. The pts wound up taking less oral pain meds.

Dont suppose you have the title of her work? thanks

[hypnotic_nurse]

I wasn't able to find the one on pressure ulcers. But I did find this one, with topical morphine (only mixed into silver sulfadiazine)...

Morphine-Infused silver sulfadiazine (MISS) cream for burn analgesia: a pilot study.
J Burn Care Rehabil 2001 Mar-Apr;22(2):118-23 (ISSN: 0273-8481)
Long TD; Cathers TA; Twillman R; O'Donnell T; Garrigues N; Jones T
Department of Psychiatry, The University of Kansas Medical Center, Kansas City 66160, USA.
Pain is considered the most distressing symptom of a burn wound, with analgesia usually provided via oral or parenteral medications. Use of systemic opioids can be complicated by fluctuations in bioavailability, absorption, and clearance of drugs caused by the burn. There has been little research done in the area of topical medications for burn analgesia. The following is a double-blind, placebo-controlled pilot study assessing the safety (side effects) and efficacy (pain ratings and medications administered) of morphine-infused silver sulfadiazine cream for burn pain. Four patients are reported on (2 in each group). Only participants taking placebo reported side effects related to morphine and necessitated anxiolytic medications. Pain ratings in the treatment group ranged from 0 to 7 with a mean of 2.1, whereas the placebo group's ratings ranged from 2 to 8 with a mean of 5.6. The placebo group averaged 55.3 mg oral morphine per half day, whereas the treatment group averaged 42.9 mg.

The link I put in didn't work, but you can find it through medscape.com.

[madwife2002]

Thank you

[Webfoot]

Originally Posted by Nurse Hatchett

Has anyone heard of this, we just started using it on our Hospice pts, and I think it is a wonderful creation. Perfect fo the end of the life, when PO meds can't be given, and sure beats shots etc. Of cours I may just be behind the times and it may not be new to many of you. I was just real excited about it.........Amazing what excites us nurses

Been using Ativan gel....not too impressed with it....Wonder how much is absorbed and how much is left on the nurse's glove....Higher dose is necessary...