ABSTRACT
Safe and balanced analgesia is one of the corner stones in the management of critically ill patients. Patient controlled analgesia has proven to be one of the methods in achieving this goal. Combined analgesic regimes have been shown to improve pain therapy. The aim of our study is to evaluate efficacy and tolerability of morphine PCA, when used with mt ravenous proparacetamol in surgical and trauma intensive care patients. Forty-two patients were included in this prospective randomized study. Two patients were later excluded. Twenty patients received 2 grams proparacetamol every 6 hours and PCA morphine [proparacetamol and morphine group]. Another 20 patients received PCA morphine only [morphine group]. Each group had equal number of trauma and postoperative patients. Patients with head injury, liver trauma and allergy to paracetamol were excluded from the study. The total amount of morphine required for 24 hours and pain relief were evaluated. Tolerability was assessed by monitoring heart rate, blood pressure, respiratory rate, adverse effects, renal and hepatic parameters. The total morphine requirement in the proparacetamol and morphine group was significantly low [P<0.001]. Incidence of vomiting was also significantly lower in the proparacetamol and morphine group, this may be related to the amount of morphine consumption. There was no significant difference in renal and hepatic parameters. Using proparacetamol as adjuvant to patient controlled morphine analgesia, decreases total consumption and adverse effects of morphine in surgical and trauma intensive care patients