Morphine, named after the Greek god of dreams, Morpheus, was identified in Germany the early 1800s. It is closely related to opium, which has been used by centuries for its euphoric, dreamlike and pain-relieving qualities. The substance is a narcotic that has important medical uses but also demonstrates a high potential for abuse. When administered, intravenous (IV) morphine acts almost immediately to reduce a patient's pain or discomfort, sometimes with an element of euphoria. Intravenous administration, however, also has a higher and faster incidence of side effects such as respiratory depression, nausea and drug dependence.
The benefits of a morphine IV are well-known in the medical field. Pain is more easily controlled when treated immediately, before it intensifies in strength and becomes associated with underlying conditions such as anxiety and fear. The effect and side effects of morphine given intravenously, however, make it a tricky medication to administer and monitor. Toward this end, the patient-controlled anesthesia (PCA) pump was developed. A PCA pump allows a patient to self-administer small doses of morphine for pain control although the pump is programmed for maximum dosages per given time intervals.
The pros of a morphine IV are greatly enhanced when administered by a PCA pump, because there is less chance of an overdose. The patient controls when his or her pain medication is administered, which not only decreases suffering time while waiting for a nurse, it also decreases anxiety about whether and when his pain will be treated. Administration of a morphine IV also provides faster — almost immediate — pain control. Studies have shown that patients actually utilize less pain medication when allowed to self-administer via a PCA pump than they receive when medication is administered by the nursing staff. Lesser use of the medication provides less of a chance for the patient to become physically dependent upon the drug.
The cons of a morphine IV for pain control include the chance of adverse events such as an overdose for elderly, very young or underweight patients. Rarely, the nursing staff might somehow err in programming the PCA pump's maximum dosages, or the machine itself might stop working either mechanically or electronically. Side effects such as shallow breathing and nausea might also occur. The potential for drug interactions exists if the morphine IV is the patient's only intravenous access and he or she is prescribed other IV medications that are incompatible with morphine. As with all medication administered intravenously, the IV catheter might become dislodged from the vein, causing swelling and irritation at the old site and requiring the IV to be restarted at a new site.
