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Effect of topical morphine (mouthwash) on oral pain due to chemotherapy- and/or radiotherapy-induced mucositis: a randomized double-blinded study
Journal of Palliative Medicine, 10/16/09

Vayne-Bossert P et al. – These results suggest a possible analgesic effect of topical morphine in line with previous studies. However, more efforts must be made for the adjustment of systemic analgesics and the development of new alternatives to treat locally OM-associated pain.

Methods

Randomized double-blinded crossover study to evaluate the effect of topical oral application of 2‰ morphine solution in patients suffering from radiotherapy- and/or chemotherapy-induced OM
Participants assigned to either the morphine solution or placebo mouthwash received one of the solutions d 1–3 and were then switched over to the other treatment for d 4–6

Results

9 patients randomized in both groups
All patients (mean age, 55.1±3.0) except one had head and neck cancers
Mean intensity of pain associated with mucosal injury (World Health Organization [WHO] mucositis ≥ 2) was on a 10-point visual analogue scale: 6.0 &#plusmn 2.7)
The analysis of variance (ANOVA) model that included morphine or placebo, day and time of mouthwash, and mouthwash effect shows that pain alleviation 1 hour after mouthwash was significantly influenced by the gesture of the mouthwash and almost by the efficiency of morphine
Duration of pain relief was 123.7 minutes for morphine
Most other reported symptoms present at baseline and were probably associated with main disease and not secondary to the morphine mouthwash

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