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Oral-parenteral conversion factor for morphine in palliative cancer care: a prospective randomized crossover pilot study.
Göteborgs universitet.ORCID iD: 0000-0001-9623-5813
2011 (English)In: Pain Research and Treatment, ISSN 2090-1542, E-ISSN 2090-1550, Vol. 2011, article id 504034Article in journal (Refereed) Published
Abstract [en]

Objective. This pilot study clinically tests whether a conversion factor of 2 to 1 is appropriate when changing from oral to parenteral morphine administration in the treatment of cancer-related nociceptive pain and calculates the size of an adequately powered future study. Methods. Eleven outpatients with incurable cancer and well-controlled nociceptive pain were randomly assigned to either intravenous or subcutaneous morphine using half the previous oral 24-hour dose. Each group crossed over after the first three-day period. Serum concentrations of morphine and its metabolites were monitored as well as intensity of pain. Results. Oral to subcutaneous and oral to intravenous quotas of morphine concentrations were approximately 0.9. Subcutaneous to intravenous morphine quotas were 1. Conclusions. The conversion factor of 2 to 1 seems to be a reasonable average but with an obvious need for individual adjustments. Concurrent medications and substantially higher doses of morphine could potentially affect the appropriate conversion factor. An adequately powered study to validate these findings would need at least 121 patients.

Place, publisher, year, edition, pages
2011. Vol. 2011, article id 504034
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Nursing
Identifiers
URN: urn:nbn:se:esh:diva-7409DOI: 10.1155/2011/504034PubMedID: 22110926OAI: oai:DiVA.org:esh-7409DiVA, id: diva2:1305388
Available from: 2019-04-16 Created: 2019-04-16 Last updated: 2019-04-17Bibliographically approved

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