Continuous Intravenous Infusion of Morphine and Ketorolac for Postoperative Pain

Lee, Yong Tae; Kim, Dong Chan; Han, Young Jin

Abstract

Despite their sometimes fatal complications such as respiratory depression when used for postoperative pain control, intravenous and epidural narcotics remain the mainstay of treatment regimens. Because of the problems, anesthesiologists are seeking alternatives. We compared the analgesic effect and complications of continuous intravenous morphine with ketorolac. Ketorolac is a non-steroidal agent with potent analgesics and moderate anti-inflammatory activity. Forty ASA physical status I or II patients were given morphine (20 patients) or ketorolac (20 patients In the morphine group, an initial bolus dose of 2 mg i.v. was given followed by continuous infusion at a rate of 1 mg/hr for 48 hours. The ketorolac group was given initial bolus of 30 mg i.v. This was followed by continuous infusion at a rate of 3.75 mg/hr for 48 hours using a Baxter Daymate Infuser. We checked systolic, diastolic and mean arterial pressure, heart rate, visual analogue scale (VAS) and the Prince Henry Score (PHS). This was done before the initial bolus, at 5, 15, 30 and 60 min, at 2, 6, l2, 24 and 48 hours after administration. We observed the side effects nausea and vomiting, pruritus, hypotension, somnolence, urinary retention and respiratory depression. From our study we believe ketorolac in selected patients, is as effective as morphine in alleviating postoperative pain without side effects of morphine.