M. Smythe et al., COMPARISON OF 3 MORPHINE REGIMENS IN POSTSURGICAL PATIENTS USING PATIENT-CONTROLLED ANALGESIA, The Annals of pharmacotherapy, 27(6), 1993, pp. 691-694
OBJECTIVE: To compare the efficacy and toxicity of three patient-contr
olled analgesia (PCA) morphine DESIGN: A prospective, randomized, pilo
t study of three PCA morphine regimens: (1) 1 mg with 6-minute lockout
(n=10), (2) 2 mg with 12-minute lockout (n=12), and (3) 2 mg with 20-
minute lockout (n=12). SETTING: Large teaching institution. PARTICIPAN
TS: Thirty-four patients undergoing cholecystectomy or hysterectomy.MA
IN OUTCOME MEASURES: Pain scores (0=no pain, 1=mild pain, 2=moderate p
ain, 3=severe pain), sedation scores, analgesic consumption, and patie
nt attempts (patient activation of PCA device) and injections (doses a
ctually delivered) were evaluated using analysis of covariance. Distri
bution of pain and sedation scores and adverse effects were assessed u
sing Fisher's exact test. RESULTS: Data on 24 patients were evaluable.
Six patients withdrew for poor pain control (2 in group 1, 1 in group
2. and 3 in group 3). Three other patients withdrew because of advers
e effects and 1 withdrew because of pump problems. Mean morphine consu
mption did not differ significantly among the groups. Distribution of
pain and sedation scores and the number of patients with nausea were s
imilar across treatment groups. The mean injection to attempt ratio wa
s significantly smaller in group 3 (0.71 +/- 0.11) compared with group
s 1 and 2 (0.9 +/- 0.06 and 0.83 +/- 0.09. respectively; p=0.001 Adver
se events occurred similarly among treatment groups. CONCLUSIONS: No s
ignificant differences in the efficacy or toxicity of the three morphi
ne PCA regimens were identified.