| A Comparison of Intravenous Morphine and Ketorolac Using Patient-Controlled Analgesia after Total Abdominal Hysterectomy. |
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Byung Il Koh, Sang Hyun Kwak, Myung Ha Yoon, Kyung Yeon Yoo, Woong Mo Im |
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Department of Anesthesiology, Chonnam National University Medical School, Kwangju, Korea. |
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| Abstract |
BACKGROUND
Intravenous (IV) morphine is commonly used for postoperative pain management. Ketorolac has been proposed as a potent analgesic for treatment of moderate to severe pain. The purpose of this study was to determine the equianalgesic dose of morphine and ketorolac using intravenous patient-controlled analgesia (IV-PCA) system in human volunteers.
METHODS
Fourty-five patients undergoing elective total abdominal hysterectomy were randomly assigned to receive either morphine (n=22) or ketorolac (n=23) when postoperative pain first increased to 40/100 mm (by visual analogue scale; VAS). Until postoperative pain decreased to 40/100 mm, morphine and ketorolac group received repeated IV boluses of 3 mg of morphine and 18 mg of ketorolac respectively and then followed by a IV-PCA with morphine (basal infusion 0 mg/hr, PCA dose 1 mg/1 ml, lock-out interval 5 min) and ketorolac (basal infusion 0 mg/hr, PCA dose 5 mg/1ml, lock-out interval 5 min). Analgesic efficacy with VAS (0~100 mm), PCA demand ratio and rate, analgesics consumptions, patient satisfaction and side effects were compared.
RESULTS
There were no significant differences in VAS, PCA demand ratio and patient satisfaction. Mean 48-hour morphine and ketorolac consumptions were 35 (SEM=2.9) mg and 224 (SEM=16.5) mg, respectively (ratio=1:6.4). Morphine group experienced side effects such as pruritus (45%), nausea and vomiting (41%) and respiratory depression (5%). However, ketorolac group only showed side effects such as nausea and vomiting (26%).
CONCLUSION
We concluded the ratio of equianalgesic dose of morphine versus ketorolac using intravenous patient-controlled analgesia (IV-PCA) after total abdominal hysterectomy was 1 versus 6.4. |
| Key Words:
Analgesia, patient-controlled, intravenous; Analgesics, ketorolac, morphine; Surgery, total abdominal hysterectomy |
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