The new epidural injection, called DepoDur, is now available in the US to help ease pain for people undergoing major surgery, such as Cesarean sections, hip and knee replacements, and abdominal surgery.
The many methods of relieving pain after such procedures include some that require catheters or intravenous lines. But DepoDur, which uses lipid packets called liposomes to carry the morphine sulphate and extend its activity in the body, can be delivered in a single shot.
It is based on a technology called DepoFoam that allows the painkiller to be released into the epidural space over time. This may reduce the need for external tubes and pumps that are common with other forms of pain management following major surgery, according to Endo.
Gavin Martin, assistant clinical professor of anaesthesiology at Duke University Medical Centre in the US, said that treatment with DepoDur could improve the hospital experience for patients and accelerate their recovery.
Unlike common formulations of morphine that are administered epidurally, DepoDur does not require an indwelling catheter for continuous pain relief. Indwelling catheters are tubes placed in a patient's spine to deliver pain medicine. Such catheters can make it difficult for patients to move around after surgery, can increase the risk of infection and can limit options for administration of anticoagulant (blood thinning) therapy.
Another common method to relieve pain after surgery is by delivering the pain medication intravenously through patient-controlled analgesia pumps (IV PCA). Unfortunately, with IV PCA there can be equipment malfunction or patient error, leading to under- or over-delivery of medication and variable pain control.
A recent meta-analysis reported in the Journal of the American Medical Association, encompassing three decades of research, showed that epidural analgesia provides significantly better postoperative pain control compared to parenteral opioids.
"Pain control after surgery is an important factor contributing to a fast recovery," said Martin. "In fact, research shows that patients whose post-surgery pain is managed properly may have less complicated rehabilitation periods and fewer chronic pain problems than those whose pain is not managed properly."
The DepoFoam technology used in the product was provided by UK company SkyePharma. Endo licensed the exclusive rights to market DepoDur™ in the US and Canada from SkyePharma in December 2002 when the product was in Phase III clinical trial development.