Turkish Journal of Anaesthesiology & Reanimation
ORIGINAL ARTICLE

The Comparison of Intravenous Patient Controlled Analgesia with Meperidine or Morphine for Pain Management after Thoracotomy

1.

Trakya Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Edirne, Türkiye

2.

Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, İstanbul, Türkiye

3.

Trakya Üniversitesi Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Edirne, Türkiye

4.

Süreyyapaşa Göğüs Hastalıkları ve Göğüs Cerrahisi Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, İstanbul, Türkiye

5.

Trakya Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Edirne, Türkiye

Turk J Anaesthesiol Reanim 2013; 41: 1-6
DOI: 10.5152/TJAR.2013.01
Read: 325 Downloads: 171 Published: 06 October 2019

Objective: To compare the effects of intravenous patient controlled analgesia(IV-PCA) with meperidine or morphine on hemodynamic parameters and pain control after thoracotomy operations.

Methods: In this prospective study, 140 patients (ASA I-III) were randomly divided into meperidine (Group 1) and morphine (Group 2) groups. For IV-PCA in the postoperative first 24 hours, in Group I; a 50 mg loading dose, 7 mg hr-1 basal infusion, 5 mg demand dose, while, in Group II; a 5 mg loading dose, 0.5 mg hr-1 basal infusion, 0.5 mg demand dose was given,and the lock-out time was 15 minutes for both groups. The collected parameters included; systolic, diastolic, mean arterial blood pressures, heart rate, pulse-oximeter saturation, visual analog scala (VAS) and Ramsey sedation scale scores, total and additional analgesics amounts and side effects.

Results: The VAS scores at 2, 4, 16. hours in Group 1 were significantly higher than in Group 2 (p=0.08; p=0.014; p=0.031). Within group analysis revealed decreased VAS scores in comparison to preoperative values in both groups (p=0.0001). Total and additional doses of morphine in Group 1 (calculated equivalent morphine dose depending on 25% incomplete cross tolerance) were higher than Group 2 (p=0.001, p=0.0001). Systolic, mean blood pressures at 2, 4, 8, 16 hours and diastolic blood pressures at 2, 4, 8 hours were higher in Group 1 when compared to Group 2 (p<0.05). The incidence of hypotension in Group 1 was 7.1%, being lower than Group 2 (18.6%; p=0.043).

Conclusion: During post-thoracotomy pain therapy, IV-PCA with morphine provides more efficient analgesia than with meperidine. However, as hypotension is more commonly observed with morphine, its use is limited and requires a cautious approach.

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EISSN 2667-6370