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KMID : 0356919950290040531
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Korean Journal of Anesthesiology
1995 Volume.29 No. 4 p.531 ~ p.538
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Effects of Morphine, Fentanyl and Ketorolac Tromethamine, Droperidol Intravenous Infusion for Postoperative Pain control
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Abstract
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Continuous intravenous infusions of opioids can provide better pain relief than intermittent injection but may be associated with increased incidence of undesirable side effects including respiratory depression, nausea, vomiting and urinary
retention,
Ketorolac tromethamine is a now, nonsteroidal anti-inflammatory agent. It has significant analgesic properties without respiratory and cardiovascular depression. Mixing of opioids and ketorolac may lessen these complications without reducing
analgesic
effect. In six groups, we assessed the effect of postoperative pain control using morphine or fentanyl, ketorolac and droperidol.
Each group consists of 100 patients. Patients in group 1, group 2, and group 3 received 2 mg of morphine via intravenous injection following the induction of anesthesia. Patients in group 1 were then continuously infused with additional 48 mg of
morphine, patients in group 2 received additional 18 mg of morphine plus 120 mg of ketorolac, and patients in the group 3 were treated with the same protocol as group 2 but 2.5 mg of droperidol was added. For patients in group 4, group 5, and
group
6
initially received 20㎍of fentanyl after induction of anesthesia. The rest of dose were treated with similar protocols as group 1, group 3, respectively. In group 4, group 5, and group 6, morphine was substituted to 500㎍, 200㎍, and 200㎍of
fentanyl,
respectively,. In all patients, initial dose of drug was given by bolus of intravenous injection and the rest of dose was delivered via intravenous using a Baxter Two Day Infusor(r) or a Paragon 100(r)
Pain scores and side effects were recorded every twelve hours for three days. No significant difference was found detween the groups although pain control effect was excellent in all groups. Untoward effects were least in morphine or
fentanyl-ketorolac-droperidol(group 3, group6).
It could be concluded that mixing of opioids, ketorolac and droperidol would be better than opioids alone.(Korean J Anesthesiol 1995; 29: 531∼538)
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