Prospective Randomized Trial of Patient-Controlled Analgesia: RESULTS

5 Dec
2010

morphine

A total of 30 women enrolled and completed the study, 15 in each treatment group. There were no differences between the 2 groups with regard to age, height, weight, or body mass index (Table 1). None of the patients required PCA for more than 2 postoperative days. All of the patients were included in the analysis, and descriptive statistics were used to report the number of patients experiencing pain and other adverse effects on postoperative days 1 and 2 (Tables 2 and 3, respectively).


Table 1. Demographic Data for Patients Who Underwent Hysterectomy

Characteristic

Medication; Mean Value Ketamine
+
Morphine Morphine Alone (n= 15) (n= 15)

pvalue

Age (years)

49.2

47.4

0.95

Weight (kg)

71.6

76.7

0.16

Height (cm)

161.3

161.6

0.95

Body mass index (kg/m2)

27.2

29.3

0.13

There were no significant differences between the treatment groups for the primary outcome measure of pain at rest, either 24 h after surgery (p = 0.27) or 48 h after surgery (p = 0.96). Similarly, there were no significant differences between the groups in terms of secondary outcomes (nausea and vomiting, sedation, dizziness, hallucinations, dreams, and nightmares) measured on postoperative days 1 and 2. Viagra Online Canadian Pharmacy

Table 2. Adverse Effects on Postoperative Day 1

No. of Patients

Rating of Adverse Effect

Ketamine + Morphine (n = 15)

Morphine Only (n = 15)

p value*

Pain

0.27

0 (none)

0

0

1-3(mild)

7

9

4-7(moderate)

7

6

8-10(severe)

1

0

Nausea and vomiting

0.73

0 (none)

7

5

1 (mild)

1

1

2 or 3 (moderate)

5

5

4 or 5 (severe)

2

4

Sedation

0.09

0 (none)

6

1

1 (mild)

0

1

2 or 3 (moderate)

6

6

4 or 5 (severe)

3

7

Dizziness

0.33

0 (none)

5

5

1 (mild)

0

1

2 or 3 (moderate)

7

9

4 or 5 (severe)

3

0

Hallucination

>0.99

0 (none)

13

13

1 (mild)

1

0

2 or 3 (moderate)

0

2

4 or 5 (severe)

1

0

Nightmares 0 (none)

13

12

0.59

1 (mild)

2

2

2 or 3 (moderate)

0

1

4 or 5 (severe)

0

0

Dreams

0.79

0 (none)

11

11

1 (mild)

2

0

2 or 3 (moderate)

2

4

4 or 5 (severe)

0

0

*Mann-Whitney U test.

The mean total consumption of morphine was 129 mg in the group receiving morphine only and 60 mg in the group receiving ketamine and morphine combined (the latter group also received 60 mg of ketamine). There was no significant difference between the 2 groups in the total amount of drug used over 48 hours (p = 0.89).
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Table 2. Adverse Effects on Postoperative Day 1

Rating of Adverse Effect*

No. of Patients Ketamine + Morphine
Morphine Only (n
= 15) (n = 15)

p valuet

Pain

0.96

0 (none)

9

7

1-3 (mild)

2

7

4-7(moderate)

4

1

8-10 (severe)

0

0

Nausea and vomiting

0.70

0 (none)

11

10

1 (mild)

2

2

2 or3 (moderate)

1

1

4 or
5
(severe)

1

2

Sedation

0.87

0 (none)

11

11

1 (mild)

1

1

2 or 3
(moderate)

2

3

4 or 5
(severe)

1

0

Dizziness

0.15

0 (none)

10

13

1 (mild)

0

0

2 or 3
(moderate)

5

2

4 or 5
(severe)

0

0


*No patients reported hallucinations, nightmares, or dreams on postoperative day 2. tMann-Whitney U test.

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