Morphine consumption is not modified in patients with severe pain and classified by the DN4 score as neuropathic☆
Virginie Lvovschi

,x
, MDVirginie Lvovschi
Search for articles by this author
Affiliations
- Department of Emergency Medicine and Surgery, Rouen university hospital, 1 rue de Germont, 76031 Rouen cedex, France
Correspondence
- Corresponding author. Service d'Accueil des Urgences, Hôpital Charles Nicolle, 1 rue de Germont, 76031 Rouen, France.

x
Virginie Lvovschi
Search for articles by this author
Affiliations
- Department of Emergency Medicine and Surgery, Rouen university hospital, 1 rue de Germont, 76031 Rouen cedex, France
Correspondence
- Corresponding author. Service d'Accueil des Urgences, Hôpital Charles Nicolle, 1 rue de Germont, 76031 Rouen, France.

Amandine Arhan
,x
, MDAmandine Arhan
Search for articles by this author
Affiliations
- Department of Emergency Medicine and Surgery, Centre hospitalo-universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie-Paris 6, 75013 Paris, France
- Department of Anesthesiology and Critical Care, Centre hospitalo-universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie-Paris 6, 75013 Paris, France
Gaëlle Juillien
,x
, MDGaëlle Juillien
Search for articles by this author
Affiliations
- Department of Emergency Medicine and Surgery, Centre hospitalo-universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie-Paris 6, 75013 Paris, France
- Department of Anesthesiology and Critical Care, Centre hospitalo-universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie-Paris 6, 75013 Paris, France
Viviane Montout
,x
, MDViviane Montout
Search for articles by this author
Affiliations
- Department of Emergency Medicine and Surgery, Centre hospitalo-universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie-Paris 6, 75013 Paris, France
- Department of Anesthesiology and Critical Care, Centre hospitalo-universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie-Paris 6, 75013 Paris, France
Mouhssine Bendahou
,x
, MDMouhssine Bendahou
Search for articles by this author
Affiliations
- Department of Emergency Medicine and Surgery, Centre hospitalo-universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie-Paris 6, 75013 Paris, France
- Department of Anesthesiology and Critical Care, Centre hospitalo-universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie-Paris 6, 75013 Paris, France
Hélène Goulet
,x
, MDHélène Goulet
Search for articles by this author
Affiliations
- Department of Emergency Medicine and Surgery, Centre hospitalo-universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie-Paris 6, 75013 Paris, France
- Department of Anesthesiology and Critical Care, Centre hospitalo-universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie-Paris 6, 75013 Paris, France
Khaled Saïdi
,x
, MDKhaled Saïdi
Search for articles by this author
Affiliations
- Department of Emergency Medicine and Surgery, Centre hospitalo-universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie-Paris 6, 75013 Paris, France
- Department of Anesthesiology and Critical Care, Centre hospitalo-universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie-Paris 6, 75013 Paris, France
Bruno Riou
x
, MD, PhDBruno Riou
Search for articles by this author
Affiliations
- Department of Emergency Medicine and Surgery, Centre hospitalo-universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie-Paris 6, 75013 Paris, France
- Department of Anesthesiology and Critical Care, Centre hospitalo-universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie-Paris 6, 75013 Paris, France
Article Info
Publication History
Published Online: July 16, 2012Accepted: March 30, 2012; Received in revised form: March 30, 2012; Received: March 8, 2012;
References
- [1]A American Society for Pain Management Nursing (ASPMN), Emergency Nurses Association (ENA), American College of Emergency Physicians (ACEP), American Pain Society (APS. Optimizing the treatment of pain in patients with acute presentations. Policy statement. Ann Emerg Med. 2010;56:77–79.
- Abstract
- | Full Text
- | Full Text PDF
- | PubMed
- | Scopus (6)
- [2]Chang, A.K., Bijur, P.E., Davitt, M., Gallagher, E.J. Randomized clinical trial comparing a patient-driven titration protocol of intravenous hydromorphone with traditional physician-driven management of emergency department patients with acute severe pain. Ann Emerg Med. 2009;54:61–67.
- [3]Lvovschi, V., Aubrun, F., Bonnet, P. et al, Intravenous morphine titration to treat severe pain in the ED. Am J Emerg Med. 2008;26:676–682.
- Abstract
- | Full Text
- | Full Text PDF
- | PubMed
- | Scopus (42)
- [4]Pines, J.M., Hollander, J.E. Emergency department crowding is associated with poor care for patients with severe pain. Ann Emerg Med. 2008;51:1–5.
- Abstract
- | Full Text
- | Full Text PDF
- | PubMed
- | Scopus (205)
- [5]Ricard Guéant, S., Taleb, A., Borel-Kühner, J. et al, Quality of pain management in the emergency department: results of a multicentre prospective study. Eur J Anaesthesiol. 2011;28:97–105.
- [6]Rupp, T., Delaney, K.A. Inadequate analgesia in emergency medicine. Ann Emerg Med. 2004;43:494–503.
- Abstract
- | Full Text
- | Full Text PDF
- | PubMed
- | Scopus (279)
- [7]Simonnet, G., Rivat, C. Opioid-induced hyperalgesia: abnormal or normal pain?. Neuroreport. 2003;14:1–7.
- [8]Woolf, C.J., Max, M.B. Mechanism-based pain diagnosis: issues for analgesic drug development. Anesthesiology. 2001;95:241–249.
- [9]Attal, N., Cruccu, G., Baron, R. et al, EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol. 2010;17:1113–1123.
- [10]Treede, R.D., Jensen, T.S., Campbell, J.N. et al, Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology. 2008;70:1630–1635.
- [11]Bouhassira, D., Attal, N., Fermanian, J. et al, Development and validation of the Neuropathic Pain Symptom Inventory. Pain. 2004;108:248–257.
- Abstract
- | Full Text
- | Full Text PDF
- | PubMed
- | Scopus (381)
- [12]Torrance, N., Smith, B.H., Bennett, M.I. et al, The epidemiology of chronic pain with neuropathic characteristics in the general population. J Pain. 2006;7:281–289.
- Abstract
- | Full Text
- | Full Text PDF
- | PubMed
- | Scopus (336)
- [13]Toth, C., Lander, J., Wiebe, S. The prevalence and impact of chronic pain with neuropathic pain symptoms in the general population. Pain Med. 2009;10:918–929.
- [14]Arnér, S., Meyerson, B.A. Lack of analgesic effect of opioids on neuropathic and idiopathic forms of pain. Pain. 1988;33:11–23.
- [15]Eisenberg, E., McNicol, E., Carr, D.B. Opoids for neuropathic pain. Cochrane Database Syst Rev. 2006;3:CD006146–CD.
- [16]Eisenberg, E., McNicol, E.D., Carr, D.B. Efficacy of mu-opioid agonists in the treatment of evoked neuropathic pain: systematic review of randomized controlled trials. Eur J Pain. 2006;10:667–676.
- [17]Havashida, K., Obata, H., Nakajima, K., Eisenach, J.C. Gabapentin acts within the locus coeruleus to alleviate neuropathic pain. Anesthesiology. 2008;109:1077–1084.
- [18]Bennett, M.I., Attal, N., Backonja, M.M. et al, Using screening tools to identify neuropathic pain. Pain. 2007;127:199–203.
- Abstract
- | Full Text
- | Full Text PDF
- | PubMed
- | Scopus (264)
- [19]Bouhassira, D., Attal, N., Alchaar, H. et al, Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain. 2005;114:29–36.
- Abstract
- | Full Text
- | Full Text PDF
- | PubMed
- | Scopus (660)
- [20]Lecomte, F., Gault, N., Koné, V. et al, Prevalence of neuropathic pain in emergency patients: an observational study. Am J Emerg Med. 2011;29:43–49.
- Abstract
- | Full Text
- | Full Text PDF
- | PubMed
- | Scopus (8)
- [21]Sterling, M., Pedler, A. A neuropathic pain component is common in acute whiplash and associated with a more complex clinical presentation. Man Ther. 2009;14:173–179.
- Abstract
- | Full Text
- | Full Text PDF
- | PubMed
- | Scopus (27)
- [22]Van Wilgen, C.P., Keizer, D. Neuropathic pain mechanisms in patients with chronic sports injuries: a diagnostic model useful in sports medicine?. Pain Med. 2011;12:110–117.
- CrossRef
- | PubMed
- | Scopus (7)
- [23]Woolf, C.J., Mannion, R. Neuropathic pain: aetiology, symptoms, mechanisms, and management. Lancet. 1999;353:1959–1964.
- [24]Harris, J.T., Suresh Kumar, K., Rajagopal, M.R. Intravenous morphine for rapid control of severe cancer pain. Palliat Med. 2003;17:248–256.
- [25]Mercadante, S., Villari, P., Ferrera, P., Casuccio, A., Fulfaro, F. Rapid titration with intravenous morphine for severe cancer pain and immediate oral conversion. Cancer. 2002;95:203–208.
- [26]Aubrun, F., Kalfon, F., Mottet, P. et al, Adjunctive analgesia with intravenous propacetamol does not reduce morphine-related adverse effects. Br J Anaesth. 2003;90:314–319.
- [27]Van Seventer, R., Vos, C., Meerding, W. et al, Linguistic validation of the DN4 for use in international studies. Eur J Pain. 2010;14:58–63.
- [28]DeLoach, L.J., Higgins, M.S., Caplan, A.B., Stigg, J.L. The visual analog scale in the immediate postoperative period: intrasubject variability and correlation with a numeric scale. Anesth Analg. 1998;86:102–106.
- [29]Paoloni, R., Talbot-Stern, J. Low incidence of nausea and vomiting with intravenous opiate analgesia in the ED. Am J Emerg Med. 2002;20:604–608.
- Abstract
- | Full Text
- | Full Text PDF
- | PubMed
- | Scopus (9)
- [30]Backonja, M.M. Defining neuropathic pain. Anesth Analg. 2003;97:785–790.
- [31]Bouhassira, D., Attal, N. Diagnosis and assessment of neuropathic pain: the saga of clinical tools. Pain. 2010;152:S74–S83.
- [32]Bouhassira, D., Lantéri-Minet, M., Attal, N., Laurent, B., Touboul, C. Prevalence of chronic pain with neuropathic characteristics in the general population. Pain. 2008;136:380–387.
- Abstract
- | Full Text
- | Full Text PDF
- | PubMed
- | Scopus (418)
- [33]Freynhagen, R., Baron, R., Tölle, T. et al, Screening of neuropathic pain components in patients with chronic back pain associated with nerve root compression: a prospective observational pilot study (MIPORT). Curr Med Res Opin. 2008;22:529–537.
- [34]Galer, B.S., Jensen, M.P. Development and preliminary validation of a pain measure specific to neuropathic pain: the Neuropathic Pain Scale. Neurology. 1997;48:332–338.
- [35]Gilron, I., Bailey, J., Weaver, D.F. et al, Patients' attitudes and prior treatments in neuropathic pain: a pilot study. Pain Res Manag. 2002;7:199–203.
- [36]Finnerup, N.B., Sindrup, S.H., Jensen, T.S. The evidence for pharmacological treatment of neuropathic pain. Pain. 2010;150:573–581.
- Abstract
- | Full Text
- | Full Text PDF
- | PubMed
- | Scopus (416)
- [37]Ong, E.C. Controlled-release oxycodone in the treatment of neuropathic pain of non-malignant and malignant causes. Oncology. 2008;74:72–75.
- [38]Hervera, A., Negrete, R., Leanez, S., Martin-Campo, J.M., Pol, O. Peripheral effects of morphine and expression of μ-opioid receptors in the dorsal root ganglia during neuropathic pain: nitric oxide signalling. Mol Pain. 2011;7:25.
- [39]Aubrun, F., Langeron, O., Quesnel, C., Coriat, P., Riou, B. Relationship between measurement of pain using visual analog score and morphine requirements during postoperative intravenous morphine titration. Anesthesiology. 2003;98:1415–1421.
☆Funding and support: The study was supported only by institutional sources.
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
Access this article on
Visit ScienceDirect to see if you have access via your institution.
Related Articles
Searching for related articles..
