Morphine/ondansetron PCA for postoperative pain, nausea, and vomiting after skull base surgery.
OBJECTIVE
Patients who underwent skull base procedures have been noted to experience appreciable pain. This study examines pain after surgery and the effectiveness of patient controlled analgesia (PCA) with combination morphine ondansetron for analgesia and control of emesis.


METHODS
A total of 120 skull base surgery patients were randomized to receive placebo, morphine, or morphine ondansetron. Demographic and intraoperative variables were recorded along with pain, nausea, vomiting, and rescue analgesics. Total PCA use, hospital stay, satisfaction, and cost were also compared.


RESULTS
Demographically the groups were similar. Pain was elevated with placebo PCA, and this group averaged twice as many analgesic rescues. Total usage time was lower with placebo PCA. Morphine ondansetron PCA had the lowest pain score with highest satisfaction. Nausea and vomiting was similar but female patients had more vomiting regardless of PCA group.


CONCLUSIONS
The use of morphine PCA reduced pain and did not appreciably increase nausea or vomiting. The addition of ondansetron produced no real benefit and its PCA use cannot be justified.


METHODS
A-1b.
Jellish
W Scott
WS
Department of Anesthesiology, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153, USA. wjellis@lumc.edu
Leonetti
John P
JP
Sawicki
Kristina
K
Anderson
Douglas
D
Origitano
Thomas C
TC
D000293:Adolescent; D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure; D003399:Craniotomy; D004338:Drug Combinations; D005260:Female; D006339:Heart Rate; D006801:Humans; D015192:Infratentorial Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use*; D017294:Ondansetron / Q000008:administration & dosage / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000517:prevention & control*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011184:Postoperative Period
D000701:Analgesics, Opioid; D000932:Antiemetics; D004338:Drug Combinations; D017294:Ondansetron; D009020:Morphine