A randomized clinical study comparing the analgesic efficacy of intra venous patient- controlled analgesia of morphine with fentanyl in post-operative pain management of major surgery patients

Brijesh Kumar; Suresha K Ramakrishnappa; Maina Bekal

doi:10.5455/njppp.2018.8.1039208102017

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Online Published: 24 Oct 2017

Natl J Physiol Pharm Pharmacol. 2017; 7(12): 1422-1427

doi: 10.5455/njppp.2018.8.1039208102017

A randomized clinical study comparing the analgesic efficacy of intra venous patient- controlled analgesia of morphine with fentanyl in post-operative pain management of major surgery patients

Brijesh Kumar, Suresha K Ramakrishnappa, Maina Bekal.

Abstract
Background: Post-operative pain is a protective but an unwanted effect which is to be treated for the better outcome of surgery.

Aims and Objectives: The aim of this study is to compare the safety and analgesic efficacy of intravenous patient-controlled analgesia (IV PCA) using morphine and fentanyl for post-operative pain management in major surgery patients.

Materials and Methods: The randomized clinical study initiated after the ethics committee approval and informed consenting. A total of 60 patients belonging to the American Society of Anesthesiology Grade - I, II, and III physical status, scheduled for major abdominal, oncological surgeries under general anesthesia were randomly allocated to two groups. Group M received IV PCA with morphine (basal continuous infusion 0.02 mg/kg/h, bolus dose of 0.02 mg/kg, and lockout period of 20 min), and the Group F received IV PCA with fentanyl (basal continuous infusion 0.5 μg/kg/h, bolus dose of 0.5 μg/kg, and lockout period of 20 min). Fentanyl dosage was converted into morphine equivalents. The outcomes such as visual analog scale (VAS), sedation score, hemodynamic parameters, and adverse effects were compared between groups and analyzed statistically.

Results: Morphine provides better analgesia than fentanyl as indicated by lower VAS scores (score = 3) at the end of 24-72 h. Mean cumulative analgesic consumption was higher in fentanyl group (436.3 ± 330.2 mg) compared with morphine group (123.9 ± 28.2 mg) by 72 h. Regarding the hourly consumption, Group M consumed less drug than fentanyl group was statistically significant (P = 0.05).

Conclusion: Morphine provides more effective post-operative analgesia than fentanyl administered through IV PCA. The PCA allows patients to balance between administration of analgesics and adverse events by self-adjusting the dose of analgesic used.

Key words: Intravenous Patient-controlled Analgesia; Fentanyl; Morphine; Post-operative Analgesia; Adverse Drug Reactions

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Pubmed Style

Kumar B, Ramakrishnappa SK, Bekal M. A randomized clinical study comparing the analgesic efficacy of intra venous patient- controlled analgesia of morphine with fentanyl in post-operative pain management of major surgery patients. Natl J Physiol Pharm Pharmacol. 2017; 7(12): 1422-1427. doi:10.5455/njppp.2018.8.1039208102017

Web Style

Kumar B, Ramakrishnappa SK, Bekal M. A randomized clinical study comparing the analgesic efficacy of intra venous patient- controlled analgesia of morphine with fentanyl in post-operative pain management of major surgery patients. https://www.njppp.com/?mno=280002 [Access: June 27, 2026]. doi:10.5455/njppp.2018.8.1039208102017

AMA (American Medical Association) Style

Kumar B, Ramakrishnappa SK, Bekal M. A randomized clinical study comparing the analgesic efficacy of intra venous patient- controlled analgesia of morphine with fentanyl in post-operative pain management of major surgery patients. Natl J Physiol Pharm Pharmacol. 2017; 7(12): 1422-1427. doi:10.5455/njppp.2018.8.1039208102017

Vancouver/ICMJE Style

Kumar B, Ramakrishnappa SK, Bekal M. A randomized clinical study comparing the analgesic efficacy of intra venous patient- controlled analgesia of morphine with fentanyl in post-operative pain management of major surgery patients. Natl J Physiol Pharm Pharmacol. (2017), [cited June 27, 2026]; 7(12): 1422-1427. doi:10.5455/njppp.2018.8.1039208102017

Harvard Style

Kumar, B., Ramakrishnappa, . S. K. & Bekal, . M. (2017) A randomized clinical study comparing the analgesic efficacy of intra venous patient- controlled analgesia of morphine with fentanyl in post-operative pain management of major surgery patients. Natl J Physiol Pharm Pharmacol, 7 (12), 1422-1427. doi:10.5455/njppp.2018.8.1039208102017

Turabian Style

Kumar, Brijesh, Suresha K Ramakrishnappa, and Maina Bekal. 2017. A randomized clinical study comparing the analgesic efficacy of intra venous patient- controlled analgesia of morphine with fentanyl in post-operative pain management of major surgery patients. National Journal of Physiology, Pharmacy and Pharmacology, 7 (12), 1422-1427. doi:10.5455/njppp.2018.8.1039208102017

Chicago Style

Kumar, Brijesh, Suresha K Ramakrishnappa, and Maina Bekal. "A randomized clinical study comparing the analgesic efficacy of intra venous patient- controlled analgesia of morphine with fentanyl in post-operative pain management of major surgery patients." National Journal of Physiology, Pharmacy and Pharmacology 7 (2017), 1422-1427. doi:10.5455/njppp.2018.8.1039208102017

MLA (The Modern Language Association) Style

Kumar, Brijesh, Suresha K Ramakrishnappa, and Maina Bekal. "A randomized clinical study comparing the analgesic efficacy of intra venous patient- controlled analgesia of morphine with fentanyl in post-operative pain management of major surgery patients." National Journal of Physiology, Pharmacy and Pharmacology 7.12 (2017), 1422-1427. Print. doi:10.5455/njppp.2018.8.1039208102017

APA (American Psychological Association) Style

Kumar, B., Ramakrishnappa, . S. K. & Bekal, . M. (2017) A randomized clinical study comparing the analgesic efficacy of intra venous patient- controlled analgesia of morphine with fentanyl in post-operative pain management of major surgery patients. National Journal of Physiology, Pharmacy and Pharmacology, 7 (12), 1422-1427. doi:10.5455/njppp.2018.8.1039208102017

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