Clinical Review

Nalbuphine and slow release morphine

BMJ 2004; 328 doi: http://dx.doi.org/10.1136/bmj.328.7453.1426 (Published 10 June 2004) Cite this as: BMJ 2004;328:1426
  1. Jason Smith, specialist registrar ([email protected])1,
  2. Henry Guly, consultant1
  1. 1Accident and Emergency Department, Derriford Hospital, Plymouth PL6 8DH
  1. Correspondence to: J Smith

    Introduction

    Prehospital analgesia should ideally give fast and safe relief from pain without adversely affecting the clinical course of patients. Nalbuphine is the intravenous analgesic for severe pain that is most widely used by ambulance services in the United Kingdom, but morphine has now been licensed for use by paramedics and is being introduced by a number of ambulance services. We present a case highlighting an important contraindication to the use of nalbuphine.

    Case report

    A 60 year old woman fell in her garden, injuring her right leg. She had a history of renal cell carcinoma with cerebral and bony metastases, and was taking 90 mg of slow release morphine tablets twice a day to control her pain. Ambulance paramedics diagnosed a fractured femur, and her prehospital care included giving her 30 …

    View Full Text

    Sign in

    Log in through your institution

    Free trial

    Register for a free trial to thebmj.com to receive unlimited access to all content on thebmj.com for 14 days.
    Sign up for a free trial

    Subscribe