Canadian Journal of Anaesthesia

, Volume 43, Issue 3, pp 212–215 | Cite as

Comparison of morphine and morphine with ketamine for postoperative analgesia

  • Keith B. Javery
  • Todd W. Ussery
  • Herbert G. Steger
  • George W. Colclough
Reports of Investigation

Abstract

Purpose

The purpose of this study was to compare morphine with ketamine to morphine alone in a doubleblind investigation of postsurgical pain control.

Methods

Fortytwo ASA 1 and 2 patients undergoing elective microdiscectomy were administered either 1 mg · ml− 1 of morphine (n = 20) or 1 mg · ml− 1 of both morphine and ketamine (n = 22) via iv patient controlled analgesia (IVPCA). Pain relief and side effects were assessed at 24 hr after surgery.

Results

The mean (SD) visual analogue scale (VAS) pain rating of 2.3 (1.67) for patients receiving morphine with ketamine was lower (P < 0.001) than the VAS scores of patients receiving only morphine 4.5 (1.54). Patients receiving morphine and ketamine also had less difficulty with side effects, reporting less nausea (P < 0.05), pruritus (P < 0.001), and urinary retention (P < 0.05). Although dysphoria is reported to be a common side effect of ketamine, complaints of dysphoria were rare in both groups, with only one subject (5%) in the morphine with ketamine group and three (15%) subjects receiving morphine alone reporting this side effect.

Conclusion

IVPCA ketamine in combination with morphine provides superior postsurgical pain relief at lower dosage and with fewer side effects than morphine alone.

Key words

analgesia: postoperative analgesics: ketamine, morphine surgery: orthopaedic 

Résumé

Objectif

Cette étude en double aveugle visait à comparer la kétamine associée à la morphine avec la morphine seule utilisée dans le but de traiter la douleur postopératoire.

Méthode

Quarantedeux patients ASA 1 et 2 programmés pour une microdiscoïdectomie ont reçu 1 mg · ml− 1 de morphine (n = 10) ou 1 mg · ml− 1 à la fois de morphine et de kétamine iv (n = 22) par un dispositif d’analgésie autocontrôlée (PCAIV). Le soulagement et les effets secondaires ont été évalués 24 h après la chirurgie.

Résultats

La moyenne (ET) de la valeur déterminée sur une échelle visuelle analogique (EVA) de 2,3 (1,67) pour les patients qui avaient reçu morphinekétamine était plus basse (P < 0,001) que celle des patients sous morphine 4,5 (1,54). Les patients sous morphinekétamine ont eu aussi moins d’effets secondaires dont moins de nausée (P < 0,05), de prurit (P < 0,001), et de rétention urinaire (P < 0,05). Bien que la dysphorie soit un effet secondaire fréquent de la kétamine, elle a été rarement rapportée dans les deux groupes, avec un seul sujet (5%) du groupe morphinekétamine et trois du groupe morphine seule (15%).

Conclusion

En PCAIV, la kétamine associée à la morphine procure une soulagement postopératoire de la douleur à des doses plus faibles et avec moins d’effets secondaires que la morphine seule.

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Copyright information

© Canadian Anesthesiologists 1996

Authors and Affiliations

  • Keith B. Javery
    • 1
  • Todd W. Ussery
    • 1
  • Herbert G. Steger
    • 1
  • George W. Colclough
    • 1
  1. 1.Department of AnesthesiologyUniversity of Kentucky Medical CenterLexingtonUSA

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