Keck Sherry, Glennon Catherine, Ginsberg Brian
Duke University Medical Center, Durham, NC, USA.
Orthop Nurs. 2007 Mar-Apr;26(2):86-93; quiz 94-5. doi: 10.1097/01.NOR.0000265863.78103.78.
Epidural morphine as a single bolus dose has demonstrated analgesia that lasts up to 24 hours. Recent advances in drug delivery mechanisms have resulted in a formulation of morphine, DepoDur, which is a lipid-encapsulated extended-release epidural morphine that provides up to 48 hours of analgesia. The efficacy of DepoDur has been established after hip arthroplasty, lower abdominal surgery involving an incision below the umbilicus, and elective cesarean section delivery. The unique characteristics of DepoDur dictate that clinicians must be aware of the benefits and risks, and facilities must have a comprehensive system to allow for the safe administration of DepoDur. This article provides information on this novel drug delivery system, reviews research findings reported in the literature, and describes the relational collaboration system designed and implemented at Duke University Health System for safe patient care of DepoDur recipients.
硬膜外注射单次大剂量吗啡已显示出长达24小时的镇痛效果。药物递送机制的最新进展产生了一种吗啡制剂——DepoDur,它是一种脂质包裹的缓释硬膜外吗啡,可提供长达48小时的镇痛效果。DepoDur在髋关节置换术后、涉及脐下切口的下腹部手术以及择期剖宫产分娩后的疗效已得到证实。DepoDur的独特特性要求临床医生必须了解其益处和风险,医疗机构必须有一个全面的系统以确保DepoDur的安全给药。本文提供了关于这种新型药物递送系统的信息,回顾了文献中报道的研究结果,并描述了杜克大学健康系统为DepoDur接受者的安全患者护理而设计和实施的相关协作系统。