Mazumdar, A., Mishra, S., Bhatnagar, S., & Gupta, D. (2008). Intravenous morphine can avoid distressing constipation associated with oral morphine: A retrospective analysis of our experience in 11 patients in the palliative care in-patient unit. American Journal of Hospice and Palliative Care, 25, 282–284.

To describe differences in bowel function with oral or IV opioids.

Patients who were admitted to a palliative inpatient unit for pain management had data retrospectively collected related to morphine-induced constipation. After IV morphine was administered and dose requirements were determined, patients were converted to oral morphine and then discharged.

• The study reported on a sample of 11 patients with cancer.
• Mean patient age was 43 years.
• The sample comprised eight men and three women.
• Patients were included in the study if they were admitted to a palliative care unit for IV morphine.
• Patients were excluded if they had gastrointestinal malignancy or disorders.

• Single site
• Inpatient
• India

The study has clinical applicability to end-of-life and palliative care.

This was a retrospective, descriptive study.

Visual analog scale

• Patients on IV morphine did not require laxatives for bowel movements to occur.
• Of patients switched to oral morphine, seven of 11 needed laxatives during their inpatient stay and were discharged with laxative prescriptions.

Patients on IV morphine were less likely to need laxative therapy to promote bowel function compared with patients on oral morphine. All patients on oral morphine needed laxative therapy.

• The sample size was extremely small.
• The design was retrospective and descriptive only.

Implications are limited because of the small sample size and other uncontrolled variables. More research is needed to determine whether IV morphine is less constipating than oral morphine and the applicability of this information in patient care.