[putmetosleep]

Can anyone tell me the rationale/physiology of why pts with pancreatitis should not receive morhphine for pain? I've been told with pancreatitis only Demerol should be given.

[sharrie]

It is suggested that morphine and other opiates stimulate the sphincter of Odi which can induce pain in biliary disease. There is other suggestions that this is total rubbish.

Have a search through the literature, I googled morphine in acute pancreatitis and opiates and pancreatits there is loads of information.

[sharrie]

I have just found a useful link reviewing the literature and giving references if you are interested

http://www.mosbysdrugconsult.com/WOW/pu081.html

[bigmamu]

I'm a retired RN. In 2001 I had pancreatitis due to gall stone. Had a cholecystectomy at that time and recovered without futher incident. In 2006 I had a pyloroplasty for delayed gastric emptying. Three weeks later I was hospitalized for a second attack of pancreatitis. At that time I learned that pancreatitis could sometimes be caused by abdominal surgery. I have never really felt well since, although blood work has been negative. I have frequent attacks of RUQ pain, although never as severe as pancreatitis. Several months ago pain was bad enough to cause visit to ER. I was given Dilaudid and had immediate SEVERE chest pain. Work-up was negative and I went home without diagnoses. In November I was diagnosed with Type II Diabetes. In December I was in ER for rectal fistula with abscess. I was again given Dilaudid and responded with acute chest pain. Again I was not told why, but decided that I would never again take Dilaudid. This week I had anal fistulotomy. I was given morphine and responded with SEVERE chest pain (worse than surgical pain). Finally the anesthiologist told me it was caused by spasm of sphincter of Odi, brought on by Dilaudid or morphine. I was then given Demerol, which not only relieved operative, but chest pain as well. I have since taken Hycodone. He told me to list Dilaudid and morphine as drug allergies. I plan on seeing a gastroenterologist.