Morphine Sulphate (Burns Analgesia)

How it works

It is an agonist at mu-opioid receptors in the central nervous system, inhibiting ascending nociceptive transmission and altering the perception of and response to pain.

Prescribing in practice

• Titrate to effect with close observation for respiratory depression and sedation, monitoring oxygen saturation and conscious level, and have naloxone available.
• Burns produce dynamic and often escalating pain with hyperalgesia and opioid tolerance, so requirements may be high and are best managed within a multimodal regimen and on a background-plus-procedural model.
• Active metabolites accumulate in renal impairment, so reduce frequency and monitor more closely when renal function is reduced, which is common in major burns.

Monitoring

Monitor pain scores, respiratory rate, sedation and oxygen saturation during titration, with continuous observation for procedural dosing.

Counselling the patient

• This strong painkiller will be adjusted to your pain and monitored closely.
• Tell staff if you feel very drowsy, sick or short of breath.
• Constipation is common and laxatives are usually given alongside.

Evidence & guidelines

Opioids including morphine are recommended as core burns analgesia by burn-care guidance, used within a multimodal, procedural-and-background framework.