Morphine Mouthwash in Oral Mucositis: A Mini Review

Kalpajit Dutta and Rakesh Garg*

Morphine Mouthwash in Oral Mucositis: A Mini Review.

Oral mucositis is a frequent adverse effect of chemotherapy and radiation therapy in cancer
patients. A multimodal therapy is advocated for management of oral
mucositis in cancer patients and includes certain preventive and therapeutic interventions aiming at symptom control.

The use of oral submucosal route for opioids has been advocated in view
of existence of peripheral opioid receptors for its analgesic property. We review the literature for use of morphine mouthwash for management of painful oral mucosisits.

Cancer patients require multidisciplinary approach including
chemotherapy and radiation therapy. Apart from other therapy associated
side effects, oral mucositis remains a major concern for patient undergoing chemotherapy and/or radiation therapy.

The oral mucositis is associated with chemo-radiation of head and
neck cancer primarily. The usual chemotherapeutic drug regimen for patients
with unresectable, locally advanced cancer is combination of cisplatin and 5-fluorouracil with concurrent radiation.

The 5-FU-based chemotherapies have more risk of mucositis. The
mucositis occurrence and its severity remain dose dependent. Continuous
infusion of chemotherapeutic drugs leads to increased risk of developing mucositis.

The cancer patients receiving such combination of chemotherapeutic
drugs along with radiation therapy remains at risk of painful mucositis which may
result in interruptions of subsequent treatment.

The treatment related oral mucositis remains painful with variable intensity and at
times severe pain leading to patient distress. It may affect
overall QoL with decrease oral intake, painful deglutition, affect sleep and may result in serious clinical complications.

Palliat Med Hosp Care Open J. 2016; 2(2): 26-29. doi: 10.17140/PMHCOJ-2-115