J Korean Acad Nurs.  2008 Oct;38(5):720-729. 10.4040/jkan.2008.38.5.720.

The Effects of Preemptive Analgesia of Morphine and Ketorolac on Postoperative Pain, Cortisol, O2 Saturation and Heart Rate

• Seo YJ
• Yoon H

• KMID: 1125538
• DOI: http://doi.org/10.4040/jkan.2008.38.5.720

Abstract

PURPOSE: This study investigated the preemptive analgesic effects of Morphine and Ketorolac on postoperative pain, cortisol, O2 saturation and heart rate for the first 24 hr after abdominal surgery.
METHODS
Data collection was performed from April 1 to September 30, 2006. Forty patients undergoing a gastrectomy under general anesthesia were randomly allocated to the experimental or control group. The experimental group (20 patients) was administered Morphine and Ketorolac approximately 1 hr prior to skin incision, but the control group (20 patients) was administered Morphine and Ketorolac at peritoneum closure through a patient-controlled analgesia (PCA) pump. Postoperative pain, blood pressure, heart rate, cortisol, O2 saturation, frequency of the PCA button pressed and doses of additional analgesics were observed through post operative 24 hr. Collected data was analyzed using t-test, chi-square test, repeated measures ANOVA, and Bonferroni methods.
RESULTS
Postoperative pain, cortisol, the frequency of PCA button pressed, and dose of additional analgesics of the experimental group were significantly lower than the control group. There were no statistical differences in blood pressure, heart rate and O2 saturation between the experimental group and control group.
CONCLUSIONS
We concluded that administration of morphine and ketorolac at 1 hr prior to skin incision resulted in decreasing postoperative pain, but it didn't affect blood pressure, heart rate or O2 saturation for 24 hr after abdominal surgery.

Keyword

Analgesia; Morphine; Ketorolac

MeSH Terms

Aged
Analgesics/*administration & dosage
Blood Pressure
Female
Heart Rate
Humans
Hydrocortisone/analysis
Injections, Intravenous
Ketorolac/*administration & dosage
Male
Middle Aged
Morphine/*administration & dosage
Oximetry
Pain Measurement
Pain, Postoperative/*prevention & control

Figure

• 

  Figure 1 Pain by VAS between experimental and control group. Exp=Experimental group (n=20); Con=Control group (n=20); RR1=Right after arriving at recovery room; RR2=Right before leaving recovery room; Postop 24=Postoperative 24 hr; †=comparison between con and exp. †***Con>Exp (p<.0001); ***p<.0001 be tween RR1 and postop 24.

• 

  Figure 2 Cortisol between experimental and control group. Exp=Experimental group (n=20); Con=Control group (n=20); Preop=Preoperative; Op 3=Operative 3 hr; RR1=Right after arriving at recovery room; Postop 24=Postoperative 24 hr; †=comparison between con and exp. †***Con>Exp (p<.0001).

• 

  Figure 3 Systolic blood pressure between experimental and control group. Exp=Experimental group (n=20); Con=Control group (n=20); Preop=Preoperative; Op 3=Operative 3 hr; RR1=Right after arriving at recovery room; RR2=Right before leaving recovery room; Postop 24=Postoperative 24 hr. ***p<.0001 between preop and op 3; **p=.001 between preop and postop 24.

• 

  Figure 4 Diastolic blood pressure between experimental and control group. Exp=Experimental group (n=20); Con=Control group (n=20); Preop=Preoperative; Op 3=Operative 3 hr; RR1=Right after arriving at recovery room; RR2=Right before leaving recovery room; Postop 24=Postoperative 24 hr. ***p<.0001 between preop and op 3; **p=.005 between preop and postop 24.

• 

  Figure 5 Heart rate between experimental and control group. Exp=Experimental group (n=20); Con=Control group (n=20); Preop=Preoperative; Op 3=Operative 3 hr; RR1=right after arriving at recovery room; RR2=right before leaving recovery room; Postop 24=Postoperative 24 hr.

• 

  Figure 6 O2 saturation between experimental and control group. Exp=Experimental group (n=20); Con=Control group (n=20); Preop=preoperative; RR1=Right after arriving at recovery room; RR2=Right before leaving recovery room; †=comparison between con and exp. †***Con

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