Which medications in the drug class Opiate Analgesics are used in the treatment of Pneumothorax?

Updated: Apr 28, 2020
  • Author: Brian J Daley, MD, MBA, FACS, FCCP, CNSC; Chief Editor: Mary C Mancini, MD, PhD, MMM  more...
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Answer

Opiate Analgesics

Opiate analgesic agents are used for pain control, which is essential to good patient care, ensures patient comfort, and promotes pulmonary toilet. Most analgesics have sedating properties, which are beneficial for patients with painful skin lesions. These drugs are important in the initial placement of thoracostomy tubes and for controlling pain after the procedure.

Fentanyl citrate (Sublimaze)

The onset of analgesia with fentanyl citrate is immediate with intravenous (IV) administration, and the duration of analgesia is 30-60 minutes. However, the respiratory depressant effect may last longer than analgesia. The dose should be individualized, and vital signs should be monitored in routinely.

Morphine (Astramorph, Infumorph 200, MS Contin, Oramorph SR)

Morphine is the drug of choice for analgesia because of its reliable and predictable effects, safety profile, and ease of reversibility with naloxone.

In adults, the initial dose is given intravenously and titrated for effect. Recommended doses begin at 0.1 mg/kg, but practically the regimen is 1-2 mg IV. The dose may be repeated at frequent intervals until analgesia is reached, and then the interval is lengthened. For most adults, the usual upper limit during the acute event is 10-15 mg over the first 4 hours. Morphine IV, delivered via patient-controlled analgesia machines, is set to get 1-2 mg on demand every 6 minutes, with a 4-hour lockout of 30 mg. Conversion to oral narcotics is accomplished as soon as possible.

In neonates, the dose is 0.05-0.2 mg/kg IV/IM/SC as needed; in children, the dose is 0.1-0.2 mg/kg IV/IM/SC q2-4h as needed. As in adults, the IV doses vary and the drug should be titrated for the desired effect.


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