Does Morphine Influence Blood Count in Palliative Patients? : A Longitudinal Study from an Oncology Center in Nepal

Sirisa Karki, Sameer Timilsina and Sabitri Sharma

Introduction: Morphine has been the cornerstone of pain management in palliative care patients. The easy accessibility and availability of opioids at most tertiary care centers of Nepal have made possible, the once thought impossible fundamental right of palliative patients. The availability of morphine has not only eased the pain of palliative patients but health care providers equally. The mainstay of pain management has had its success but several subjective complaints of dry mouth, sedation, feeling of incomplete wellbeing and decreased immune function is often heard of. The present study aims at evaluating the effects of morphine on complete blood count profile in palliative care patients.

Methods: Complete blood count of 114 palliative patients was estimated using an automatic hematology analyzer after 24-48 hours and 14 days of morphine administration. The data was recorded using a preformed proforma and analyzed using SPSS (20).

Results: A statistically significant increase in total white blood cell count, neutrophil and platelet count was observed following morphine administration but there was a decrease in lymphocyte count (p0.05).

Conclusion: Morphine is found to influence the total white blood cells, neutrophils, and lymphocytes and NLR in palliative patients. However, withholding morphine in palliative patients is never an option. Furthermore, larger randomized controlled trials are necessary to analyze the predictive value of NLR and PLR in palliative patients.