title: Pain management of living liver donors with morphine with or without ketorolac.
abstract: BACKGROUND
  To compare the efficacy and dose requirements for intravenous (IV) patient-controlled analgesia (PCA) with morphine only versus morphine with ketorolac for living liver donors after partial hepatectomy.
  
  
  METHODS
  Eighty living liver donors who had undergone partial hepatectomy received 3 days of IV PCA for postoperative pain control. Some were prescribed a PCA with morphine alone (group I) or morphine with ketorolac (group II), while both had a rescue dose of IV fentanyl (25 μg). The daily consumption of morphine, pain score, and frequency of rescue fentanyl doses were compared retrospectively using the Mann-Whitney U test and the incidence of side effects with chi-square tests; a P value of .05 was regarded as significant. All the data are shown as mean values±standard deviations.
  
  
  RESULTS
  The 80 subjects were distributed as 57 group I and in 23 group II patients. The daily consumption of morphine, Visual Analogue Scale (VAS) and side effects were not different between the groups, but group II required significantly fewer rescue doses to achieve pain relief.
  
  
  CONCLUSIONS
  Both regimens provided acceptable pain control with daily VAS less than 3. The use of ketorolac in the PCA did not reduce the daily total morphine requirements with a similar incidence of side effects but a significantly reduced requirement for rescue doses, which subsequently reduced the work load of personnel in the pain control service.
authors.affiliation: Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, Taiwan.
authors.forename: C-W
authors.initials: CW
authors.lastname: Kao
authors.forename: S-C
authors.initials: SC
authors.lastname: Wu
authors.forename: K-C
authors.initials: KC
authors.lastname: Lin
authors.forename: C-L
authors.initials: CL
authors.lastname: Chen
authors.forename: C-J
authors.initials: CJ
authors.lastname: Huang
authors.forename: K-W
authors.initials: KW
authors.lastname: Cheng
authors.forename: B
authors.initials: B
authors.lastname: Jawan
authors.forename: C-H
authors.initials: CH
authors.lastname: Wang
mesh_terms: D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D004359:Drug Therapy, Combination; D005283:Fentanyl / Q000627:therapeutic use; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D020910:Ketorolac / Q000009:adverse effects / Q000627:therapeutic use*; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D059408:Pain Management / Q000009:adverse effects; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D009020:Morphine; D005283:Fentanyl; D020910:Ketorolac