A mouthwash containing a morphine solution was examined for its effect on oral mucositis and on acute pain from oral mucositis in patients with cancer.
Sarvizadeh, M., Hemati, S., Meidani, M., Ashouri, M., Roayaei, M., & Shahsanai, A. (2015). Morphine mouthwash for the management of oral mucositis in patients with head and neck cancer. Advanced Biomedical Research, 4, 44-9175.151254. eCollection 2015.
To investigate the efficacy of topical morphine compared to routine therapy (magic mouthwash) in the management of oral mucositis in patients with head and neck cancer
In the study group, 10 ml of morphine sulfate 2% was given every three hours, six times per day for six days while the control group received 10 ml magic mouthwash (240 ml of magnesium hydroxide, 25 ml of 2% viscous lidocaine, and 60 ml of diphenhydramine) on the same schedule. The intervention was initiated when patients with head and neck cancer presented with grade 3 or 4 mucositis from chemotherapy, radiotherapy, or chemoradiotherapy. Patients in both arms were instructed to hold the solution in thier mouths for at least two minutes and to not swallow.
Randomized, double-blinded, controlled study
No significant difference in treatments were found on the third day. On day 6, there was a significant reduction in mucositis severity in patients in the morphine arm (p = 0.045). The trend in mucositis change showed a decrease in severity in both arms.
Both morphine and magic mouthwash were effective in reducing mucositis severity. However, topical morphine was more effective, and its results were more satisfactory to patients than the magic mouthwash.
More studies in larger populations are needed for this intervention. Its comparison to magic mouthwash was questionable because it is not effective in reducing mucositis severity.