Barriers to the use of morphine for the management of severe postoperative pain-A before and after study

Aim: To reduce the number of patients experiencing severe postoperative pain by prescribing 10mg Morphine either as oral solution or by IM injection as an alternative to Tramadol Hydrochloride in an analgesic protocol. Materials and methods: Patients who received in-patient oral and maxillofacial surgery under general anaesthesia were included. Complex intervention analgesic protocols were developed including staff education, patient educations and analgesic protocols. 80 patients were treated under the original protocol (tramadol hydrochloride for pain unmanaged by other drugs in protocol) over 4 months. 75 patients were treated under the second protocol (oral or intravenous morphine for pain unmanaged by other drugs in protocol). Patient perceptions to their pain management were then assessed. Results: Proportion of patients reporting 'no pain' increased from 5% of 80 patients to 28% of 75 patients (p