Less PONV with morphine-6-glucuronide than with morphine

Reactions 1226 - 1 Nov 2008

Less PONV withmorphine-6-glucuronide than with

morphineMorphine-6-glucouronide (M6G)* is associated with

less postoperative nausea and vomiting (PONV) thanmorphine, according to the results of an study presentedat the 2008 Annual Meeting of the American Society ofAnesthesiologists.

The study involved 517 patients undergoing majorabdominal surgery who were randomly assigned toreceive postoperative pain management based on eitherM6G (n = 268) or morphine. The M6G and morphineregimens consisted of an intraoperative loading dose(30 mg/70kg and 10 mg/70kg, respectively) and up totwo fixed doses (15mg/70kg and 5 mg/70kg,respectively) plus patient-controlled analgesia (PCA) fora minimum of 24 hours.

The AUCs for nausea scores** from 6 to 24 hours afterPCA was commenced increased, as expected, with thenumber of Apfel risk factors each patient had. Notably,for patients with one, two, three or four Apfel riskfactors, M6G was associated with 28%, 14%, 17% and29% reductions in AUC, respectively, compared withmorphine. Overall, when comparing M6G withmorphine the nausea severity was reduced by 27% withthe experimental agent in patients who receivedpostoperative opioids (p = 0.052) and by 17% in women(p= 0.034). Furthermore, the incidence of vomiting wassignificantly reduced by 34% in the M6G recipients,compared with the morphine recipients.* M6G is an active potent metabolite of morphine being developed byCeNeS Pharmaceuticals; this product is in phase III in the EU forpostoperative pain and in phase I in the US for pain.** 4-point scale: none, mild, moderate, severe

Lees JP, et al. Analysis of PONV and Apfel risk factors in a comparison betweenmorphine-6-glucuronide and morphine. 2008 Annual Meeting of the AmericanSociety of Anesthesiologists (Abstr. on disk): abstr. 1695, 18 Oct2008. 801127289

1

Reactions 1 Nov 2008 No. 12260114-9954/10/1226-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved