Does Morphine Administration Consequences Missing of Spinal Fracture Patients in the Emergency Ward?

Introduction: Studies have shown that factors that distract the patient from pain, such as more pain in other parts of the body or the use of analgesics, can impair the process of fracture diagnosis by reducing the patient’s sensitivity to the presence of tenderness during the doctor’s examination. This study investigated the effect of using analgesics as a distracting item in patients with traumatic cervical pain and tenderness and determined whether prescribing and administering analgesics to these patients caused patients with noticeable bone lesions to be examined less accurately. It also explored whether the correct administration of analgesics reduces the use of radiography. Methods: A total of 62 trauma patients with midline cervical pain who met at least one criterion for cervical CT scan imaging and required analgesics as diagnosed by the physician were included in this cross-sectional study. First, the patients’ pain scores were measured and recorded according to the Visual Analogue Scale (VAS) during the spinal examination. Subsequently, morphine at a dose of 0.05 mg/kg was administered intravenously. The pain scores of the patients were then recorded during the spinal examination at baseline and 30 minutes after administration. Subsequently, the patients were subjected to a CT scan of the cervical vertebrae, and the relationship between the pain score of the patients and the results of the CT scan was investigated. Results: The mean pain score significantly decreased in patients with a normal condition (Not Presence of Fracture) after injection (P=0.004), but this difference was not significant in patients with a fractured spine, indicating that there was no improvement in pain with the administration of morphine in patients with serious cervical injuries (P=1.000). Conclusion: In patients with cervical spine fractures, the administration of morphine did not completely alleviate the pain.