1.Investigation of an adhesion of both morphine granules (MS-twicelon, Kadian, Pacif) and morphine fine granules (Morphesfine granules) to syringe and catheter tube in administration through a nasogastric tube
Shinya Takada ; Hisae Eguchi ; Norio Kato ; Keishiro Izumi
Palliative Care Research 2008;3(2):101-107
Purpose: Morphine is often administrated through a nosogastric catheter in palliative medicine. As adhesion to the catheter and its stoppage is problematic, adhesion of morphine granules in a nosogastric-tube was investigated. Methods: We investigated it in three following conditions. (1)four morphine products, which were three morphine granules (Pacif®, MS-twicelon® and Kadian®) and a morphine fine granule (Morphes®). (2)four different suspensions of composition, which were water, milk, enteral nutrition liquid and jellied suspension liquid. (3)two sizes of nosogastric catheter (10.5Fr and 13.5Fr). Each morphine product at a dose of 30mg was diluted by each suspension of 20mL in a cup, and injected into each size of nosogastric catheters using a syringe. And the catheter was flushed by the same suspension of 20mL. We counted the granule that adhered to the cup, the syringe and the catheter. Results: As for Pacif® and MS-twicelon®, jellied suspension liquid significantly decreased the number of morphine granules adhered than any of the other suspensions (One-Way Factorial ANOVA and Scheffe's F test: p<0.05) in both sizes of catheters. Only jellied suspension liquid made Kadian® pass the both catheters, but they were obstructed by Kadian® diluted in the other suspensions. Morphes® diluted in water had a tendency to adhere compared to those in milk, enteral nutrition liquid or jellied suspension liquid. Additionally, using the jellied suspension liquid, the maximum dosing of Pacif®, MS-twicelon® and Kadian® were 240mg, 90mg and 60mg, respectively. Conclusion: When administering morphine granules through a nasogastric-tube, using jellied suspension liquid is recommended. Palliat Care Res 2008; 3(2): 101-107