Comparison of acute pain treatment guidelines
| Clinical setting . | Reference . | Protocol for intravenous morphine . | Maximum morphine in first hour of treatment, mg* . |
|---|---|---|---|
| VOC in SCD | APS2 /NIH4 | 5-10 mg then 2.5-5.0 mg every 15-30 min† | 10-30 |
| BCSH3 | 0.1 mg/kg every 20 min | 21‡ | |
| Acute coronary syndromes | ACC/AHA30 | 2-4 mg every 5 min | 25-30§ |
| Postoperative pain | YNHH PACU | 2-5 mg every 3-5 min∥ | 20-60 |
| Emergency department acute pain treatment | Harwood-Nuss'20 | 2-5 mg every 5 min | 24-60 |
| Clinical setting . | Reference . | Protocol for intravenous morphine . | Maximum morphine in first hour of treatment, mg* . |
|---|---|---|---|
| VOC in SCD | APS2 /NIH4 | 5-10 mg then 2.5-5.0 mg every 15-30 min† | 10-30 |
| BCSH3 | 0.1 mg/kg every 20 min | 21‡ | |
| Acute coronary syndromes | ACC/AHA30 | 2-4 mg every 5 min | 25-30§ |
| Postoperative pain | YNHH PACU | 2-5 mg every 3-5 min∥ | 20-60 |
| Emergency department acute pain treatment | Harwood-Nuss'20 | 2-5 mg every 5 min | 24-60 |
YNHH indicates Yale New Haven Hospital; and PACU, postanesthesia care unit.
As intravenous morphine equivalents.
See Table 1.
Based on patient weight of 70 kg.
Reference notes that 25 to 30 mg may be required.
Unpublished protocol calls for 2 mg morphine intravenously every 3 to 5 minutes if pain is moderate (maximum = 10-20 mg) or 5 mg morphine intravenously every 3 to 5 minutes if pain is severe (maximum = 60 mg).