Whether its knee replacement, lumbar spine surgery, or hysterectomy; most of the anxiety my patients have about their upcoming surgery is about pain they will have after surgery, and potential nausea and vomiting from their pain meds. Patient controlled analgesia (PCA) is often used after surgery where patients press a button to deliver their intravenous pain medications. The pain medicine delivered by PCA is usually either Morphine or Dilaudid (Hydromorphone.) Many healthcare providers believe Dilaudid causes less nausea than Morphine but until recently that had not been studied.
Does treatment with Dilaudid (hydromorphone) result in improved pain control and fewer adverse side effects than morphine for postoperative pain? It doesn’t look like it. Evidence shows that when it comes to nausea, pruritus (itching,) vomiting, sedation, pain, and patient satisfaction, the side effect profile was not different between the two drugs. The incidence of nausea did not differ between morphine and hydromorphone treated patients nor was there a difference in the amount of pain or in patient satisfaction.
The choice between morphine and hydromorphone, for postoperative pain, can be a discussion you have with your surgeon before surgery but it appears there isn’t much difference between the two.
What has your experience been?
- Dr. O.
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