Najmeh Zarei Jelyani; Razieh Sadat Mousavi-Roknabadi; Mohamad Javad Andalibi; Afsaneh Dehbozorgi; Faramarz Farahmand,
Abstract
Background: Several studies have been performed to evaluate the efficacy of different pain management techniques in patients with trauma, using different methods.Objectives: To compare Intravenous (IV) morphine vs. fentanyl for analgesic response, the time to reach lowest pain score, and adverse effects ...
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Background: Several studies have been performed to evaluate the efficacy of different pain management techniques in patients with trauma, using different methods.Objectives: To compare Intravenous (IV) morphine vs. fentanyl for analgesic response, the time to reach lowest pain score, and adverse effects in patients with trauma who were referred to Emergency Department (ED) was investigated.Methods: This double-blind randomized controlled trial (June-December 2017) was performed on adult traumatic patients, who were referred to the EDs of two main trauma centers (Affiliated to Shiraz University of Medical Sciences), in southern Iran. The inclusion criteria were acute pain >4 on a Numeric Rating Scale (NRS) 0-10 upon presentation. The patients were randomly allocated to receive a single dose of IV morphine (0.1 mg/kg) or IV fentanyl (2 µg/kg). The pain score was recorded at baseline, 5, 10, 30, and 120 minutes after administration of either morphine or fentanyl, as well as adverse effects. Then, the data were analyzed.Results: In order to carry out this study, 167 patients were enrolled. The initial NRS in both groups were similar. The mean ± SD of NRS at all times was higher in the fentanyl group, except in 10 minutes, but only in 120 minutes, this difference was statistically significant (p= 0.01). The mean ± SD of pain reduction in all times was similar in both groups. The incidence of adverse effects in both groups were not different (p = 0.18).Conclusion: According to findings, IV fentanyl had a similar analgesic effect to IV morphine in traumatic patients with acute pain. Also, there was no significant difference in terms of adverse effects between groups.
Seyed Jalal Madani; Majid Saeedi; Mohammad Saeed Gheasi; Masoud Saghafinia; Seyed Mohammad Reza Amouzegar; Ali Bahramifar; Vahid Shahkarami
Abstract
Background: Gastrointestinal surgery is one of the procedures that result to produce inflammatory reactions and pain to patients. Administrate of high-safe analgesia in surgery is very essential, to reduce pain and improve inflammatory reactions. Objectives: The present study compared inflammatory markers ...
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Background: Gastrointestinal surgery is one of the procedures that result to produce inflammatory reactions and pain to patients. Administrate of high-safe analgesia in surgery is very essential, to reduce pain and improve inflammatory reactions. Objectives: The present study compared inflammatory markers and pain relief with the epidural infusion of bupivacaine-fentanyl and intravenous morphine bolus in gastrointestinal cancer surgeries. Methods: This randomized control clinical trial study was carried out from December 2018 to October 2020, on ASA I and II patients aged between 30-80 years who referred for gastrointestinal cancer surgery. Cases were randomly distributed into two groups. Group I received epidural catheter with bupivacaine (18 cases), and group II received fentanyl and morphine bolus injection (18 cases). On the first and second days post-operation, data on pain scores based on visual analogue scale (VAS) score, inflammatory markers (procalcitonin [PCT] and C-reactive protein [CRP]), platelet (PLT), white blood cells (WBCs), and erythrocyte sedimentation rate (ESR) was recorded. Results: The mean age was 52.21±16.13 years (41.6% male, 58.4 female). The mean of ESR, CRP and PCT postoperative were significantly higher than preoperative (P < 0.05). There were no differences between the two groups regarding PLT, ESR, CRP, and PCT preoperative postoperative (P > 0.05). The mean of pain was less in the epidural group than in the morphine group postoperative (P = 0.02). Conclusion: The results showed that epidural fentanyl-bupivacaine infusion was more effective in pain reduction than the intravenous infusion of morphine in cases undergoing gastrointestinal cancer operation. However, both analgesic approaches were similar in inflammatory functions.