Evaluation of the Treatment and Safety of High Dose Intravenous Narcotics for Acute Pain in an Inpatient Setting

Objective. The primary objective of this study is to evaluate adverse drug events associated with intravenous morphine and hydromorphone at doses greater than 8 mg IV Q3 hours and 2 mg IV Q3 hours. Secondary objectives include: [1] percentage of subjects on oxygen saturation monitoring, [2] percentage of subjects prescribed and/or administered naloxone, and [3] percentage of physician orders with a PRN / as needed indication as required by the Joint Commission Standard MM.04.01.01. Methods. A computer generated list of patients prescribed high doses of intravenous morphine and/or hydromorphone will be collected and evaluated for study inclusion. Adverse drug events will be defined as one or more of the following: a reported Ramsay sedation score ≥5, respiratory rates less than 12 breaths per min, or oxygen saturation less than 95% at room air. Descriptive statistics will be used to summarize data and inferential statistics will be used to compare data. Results. At study midpoint (n=6), only one subject has displayed an adverse effect currently associated to the administration of hydromorphone 2mg intravenously; subject displayed with an oxygen saturation below normal. Conclusion. No trend is available for analysis this far; however study subject recruitment is still ongoing at this time.