title: Coadministration of intravenous remifentanil and morphine for post-thoracotomy pain: comparison with intravenous morphine alone.
abstract: OBJECTIVE
  In this double-blind, randomized study, the authors compared the effects of a patient-controlled remifentanil and morphine combination with morphine alone on post-thoracotomy pain, analgesic consumption, and side effects.
  
  
  METHODS
  A prospective, randomized, double-blind clinical study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Volunteer patients at a university hospital undergoing elective thoracotomy surgery.
  
  
  METHODS
  Patients were allocated randomly into 2 groups to receive patient-controlled analgesia: the morphine (M) group or the morphine plus remifentanil (MR) group. Pain, discomfort, sedation scores, cumulative patient-controlled morphine consumption, rescue analgesic (meperidine) requirement and side effects were recorded for 24 hours.
  
  
  RESULTS
  Sixty patients were allocated randomly to receive intravenous patient-controlled analgesia with morphine alone (M) or morphine plus remifentanil (MR) in a double-blind manner. Patients were allowed to use bolus doses of morphine (0.02 mg/kg) or the same dose of a morphine plus remifentanil (0.2 µg/kg) mixture every 10 minutes without a background infusion. VAS scores were lower in the MR group than in the M group at 30 minutes (p = 0.04), 1 hour (p = 0.03), and 2 hours (p = 0.04). Mean cumulative doses of morphine were not significantly different at 27.8±15 mg for the M group and 21.9±10.5 mg for the MR group. Significantly more patients needed meperidine in the M group (p = 0.039); these also experienced more nausea (p = 0.01).
  
  
  CONCLUSIONS
  Coadministration of PCA remifentanil with morphine for the treatment of post-thoracotomy pain did not reduce morphine consumption but provided superior analgesia, less use of rescue analgesics, and fewer side effects compared to morphine alone.
authors.affiliation: Department of Anaesthesiology, Cukurova University and Faculty of Medicine, Adana, Turkey.
authors.forename: Mediha
authors.initials: M
authors.lastname: Turktan
authors.affiliation: Department of Anaesthesiology, Cukurova University and Faculty of Medicine, Adana, Turkey. Electronic address: unlugenc@cu.edu.tr.
authors.forename: Hakki
authors.initials: H
authors.lastname: Unlugenc
authors.affiliation: Department of Anaesthesiology, Cukurova University and Faculty of Medicine, Adana, Turkey.
authors.forename: Ersel
authors.initials: E
authors.lastname: Gulec
authors.affiliation: Department of Thoracic Surgery, Cukurova University and Faculty of Medicine, Adana, Turkey.
authors.forename: Suat
authors.initials: S
authors.lastname: Gezer
authors.affiliation: Department of Anaesthesiology, Cukurova University and Faculty of Medicine, Adana, Turkey.
authors.forename: Geylan
authors.initials: G
authors.lastname: Isik
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000175:diagnosis / Q000517:prevention & control*; D010880:Piperidines / Q000008:administration & dosage*; D011446:Prospective Studies; D000077208:Remifentanil; D013908:Thoracotomy / Q000009:adverse effects
chemical_list: D000701:Analgesics, Opioid; D010880:Piperidines; D009020:Morphine; D000077208:Remifentanil
keywords: morphine; patient-controlled analgesia; post-thoracotomy pain; remifentanil