Intraspinal Use of Morphine

OBJECTIVE: To compare the different sterility standards and the cost issues involved when choosing an opioid product for intraspinal administration.DATA SOURCES: Literature accessed through MEDLINE and other Internet search engines (September 2002–April 2003) was evaluated. Key search terms included epidural/intrathecal, opioids, sterility, and compounding.DATA SYNTHESIS: Intraspinal use is prevalent in the area of pain management. Product selection is of utmost importance when administering through the intraspinal route. An evaluation of guidelines on sterility and a cost comparison were conducted.CONCLUSIONS: The preservative-free commercially available products that are indicated for intrathecal/epidural use are the best alternative due to proper outside testing and stringent quality assurance. The generic morphine preservative-free product may also be considered if proper steps are taken to ensure that the final product is diluted properly.