Morphine-dexmedetomidine mixture versus morphine alone for postoperative analgesia

To compare the quality of postoperative analgesia between intraoperative administration of Morphine-Dexmedetomidine versus Morphine alone A total of 82 adults of both gender, aged between 42 and 71 years. All according to [American Society of Anesthesiologists] class I-II were assigned for various elective abdominal operations under general balanced anesthesia at King Hussein Medical Center during the period from January to October 2010. Patients were divided into two groups. Group D [n=41] received intravenous Morphine sulphate 0.1 mg/kg and Dexmedetomidine [primary loading dose of 1 mcg/kg over 10 min. followed by 0.4 mcg/kg/h] and group M [n=41] received intravenous Morphine sulphate 0.1 mg/kg, both given half an hour before the completion of surgery. Postoperative analgesia quality was evaluated using Visual Analog Scale and Morphine consumption in the recovery room for the first 1 hour then in the surgical ward for the next 24 hours. Median pain severity score was 3 in group D and 6 in group M during the first postoperative 60 minutes and 2 minutes in group D, 3 minutes in group M after 24 hours. About 83% of patients in group M needed additional Morphine compared to 26.8% of patients in group D [P<0.05] in the recovery room to attain equivalent analgesia. Intraoperative administration of intravenous Morphine-Dexmedetomidine mixture produces higher postoperative analgesia than Morphine alone

Comparison between epidural anesthesia [bupivacaine and fentanyl] mixture and continuous intravenous morphine for pain control in the treatment of major abdominal vascular surgery at Queen Alia Hospital

To compare the use of continuous epidural analgesia [Bupivaccine and Fentanyl] mixture and continuous intravenous Morphine in regard to efficacy and side effects for the relief of postoperative pain in the treatment of abdominal vascular surgery [upper and lower abdominal surgery]. This study was conducted at Queen Alia Hospital between January 2003 and December 2005. Age range of the study participants was between 45-80 years, 85 were males and 21 were females. The patients signed a consent form for surgical and anesthesia intervention. A total of 106 patients who had coronary artery disease, diabetes mellitus, chronic obstructive pulmonary disease, chronic renal failure or more than one of these diseases [American Society of Anesthesiologists III and IV class] were divided into two treatment modalities. Group A [60 patients] received continuous epidural analgesia [Bupivacain and Fentanyl] mixture while group B [46 patients] received continuous intravenous morphine for the relief of postoperative pain in the treatment of major abdominal vascular surgery. Pain was assessed postoperatively using pain relief score. The different side effects reported included nausea and vomiting, motor block, respiratory depression and sedation. Simple descriptive statistics and the Chi-Square test were used to analyze the data. P value of < 0.05 was considered statically significant. Pain relief was better among patients in group A than those in group B [P<0 .001]. Similarly, there was a lower statistically significant difference regarding side effects among patients in group A. Patients who received continuous epidural Bupivacaine and Fentanyl experienced better pain relief and fewer complications than those in the Morphine group. Results indicate that the use of epidural anesthesia [Fentanyl and Bupivacaine] is a safe procedure and is more efficient than the continuous intravenous morphine for pain relief in the treatment of major abdominal vascular surgery