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. 2014 Sep 21;4(4):e19423.
doi: 10.5812/aapm.19423. eCollection 2014 Oct.

Comparing the effects of morphine sulfate and diclofenac suppositories on postoperative pain in coronary artery bypass graft patients

Vali Imantalab  1 , Ali Mirmansouri  2 , Abbas Sedighinejad  1 , Bahram Naderi Nabi  1 , Farnoush Farzi  1 , Hadi Atamanesh  1 , Nassir Nassiri  3
Affiliations

Comparing the effects of morphine sulfate and diclofenac suppositories on postoperative pain in coronary artery bypass graft patients

Vali Imantalab et al. Anesth Pain Med. .

Abstract

Background: Simple and efficient way of pain management after Coronary Artery Bypass Graft (CABG) surgery is an important aspect of patients' care.

Objectives: This study aimed to compare the effects of morphine and diclofenac suppositories on postoperative pain management.

Patients and methods: In this double-blinded clinical trial study, 120 patients aged 30-65 years old, undergone CABG, were equally divided into two groups of A (morphine) and B (diclofenac). All patients were anesthetized with intravenous fentanyl 10 μg/kg, etomidate 0.2 mg/kg and cisatracurium 0.2 mg/kg. Anesthesia was maintained with oxygen 50% and air 50%, propofol 50 μg/kg/min, fentanyl 1-2 μg/kg/h and atracurium 0.6 mg/kg/h. Analgesics were administered after the operation at intensive care unit (ICU) and Visual Analogue Score (VAS) was evaluated in both groups in 4-hour intervals after extubation for 24 hours. After extubation in case of VAS > 3, morphine suppository 10 mg (group A) or diclofenac suppository 50 mg (group B) was administered for patients.

Results: No significant statistical relationship was found between the two groups regarding gender, age, BMI, paracetamol consumption, length of operation time, cardiopulmonary bypass pump (CPB) time, and stay time at ICU (P Value ≥ 0.05). Total dosage of used morphine was 22 ± 8.3 mg in each patient and total dosage of used diclofenac was 94 ± 32.01 mg. Average variation of VAS at measured intervals was significant (P Value ≤ 0.0001), but these variations were not significantly different when comparing the two groups (P Value = 0.023).

Conclusions: Both morphine and diclofenac suppositories reduced pain significantly and similarly after CABG surgery.

Keywords: Cardiac Surgery; Diclofenac; Morphine; Pain.

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Figures

Figure 1.
Figure 1.. Comparison of Visual Analogue Score Changes, Measured in Different Times, in Morphine and Diclofenac Groups
See this image and copyright information in PMC

References

    1. Barnason S, Zimmerman L, Nieveen J, Schulz P, Miller C, Hertzog M, et al. Relationships between fatigue and early postoperative recovery outcomes over time in elderly patients undergoing coronary artery bypass graft surgery. Heart Lung. 2008;37(4):245–56. doi: 10.1016/j.hrtlng.2007.09.003. - DOI - PMC - PubMed
    1. Woods A, Brull DJ, Humphries SE, Montgomery HE. Genetics of inflammation and risk of coronary artery disease: the central role of interleukin-6. Eur Heart J. 2000;21(19):1574–83. doi: 10.1053/euhj.1999.2207. - DOI - PubMed
    1. Haswir H, Umbas R. Comparison of efficacy between oral morphine sulphate and diclofenac suppository for analgesia during transrectal ultrasound-guided prostate biopsy. Acta Med Indones. 2008;40(3):124–8. - PubMed
    1. Immer FF, Immer-Bansi AS, Trachsel N, Berdat PA, Eigenmann V, Curatolo M, et al. Pain treatment with a COX-2 inhibitor after coronary artery bypass operation: a randomized trial. Ann Thorac Surg. 2003;75(2):490–5. - PubMed
    1. Hynninen MS, Cheng DC, Hossain I, Carroll J, Aumbhagavan SS, Yue R, et al. Non-steroidal anti-inflammatory drugs in treatment of postoperative pain after cardiac surgery. Can J Anaesth. 2000;47(12):1182–7. doi: 10.1007/BF03019866. - DOI - PubMed

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