title: Comparing the effects of morphine sulfate and diclofenac suppositories on postoperative pain in coronary artery bypass graft patients.
abstract: BACKGROUND
  Simple and efficient way of pain management after Coronary Artery Bypass Graft (CABG) surgery is an important aspect of patients' care.
  
  
  OBJECTIVE
  This study aimed to compare the effects of morphine and diclofenac suppositories on postoperative pain management.
  
  
  METHODS
  In this double-blinded clinical trial study, 120 patients aged 30-65 years old, undergone CABG, were equally divided into two groups of A (morphine) and B (diclofenac). All patients were anesthetized with intravenous fentanyl 10 μg/kg, etomidate 0.2 mg/kg and cisatracurium 0.2 mg/kg. Anesthesia was maintained with oxygen 50% and air 50%, propofol 50 μg/kg/min, fentanyl 1-2 μg/kg/h and atracurium 0.6 mg/kg/h. Analgesics were administered after the operation at intensive care unit (ICU) and Visual Analogue Score (VAS) was evaluated in both groups in 4-hour intervals after extubation for 24 hours. After extubation in case of VAS > 3, morphine suppository 10 mg (group A) or diclofenac suppository 50 mg (group B) was administered for patients.
  
  
  RESULTS
  No significant statistical relationship was found between the two groups regarding gender, age, BMI, paracetamol consumption, length of operation time, cardiopulmonary bypass pump (CPB) time, and stay time at ICU (P Value ≥ 0.05). Total dosage of used morphine was 22 ± 8.3 mg in each patient and total dosage of used diclofenac was 94 ± 32.01 mg. Average variation of VAS at measured intervals was significant (P Value ≤ 0.0001), but these variations were not significantly different when comparing the two groups (P Value = 0.023).
  
  
  CONCLUSIONS
  Both morphine and diclofenac suppositories reduced pain significantly and similarly after CABG surgery.
authors.affiliation: Anesthesiology Department, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Vali
authors.initials: V
authors.lastname: Imantalab
authors.affiliation: Anesthesia Research Center, Dr. Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Mirmansouri
authors.affiliation: Anesthesiology Department, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Sedighinejad
authors.affiliation: Anesthesiology Department, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Bahram
authors.initials: B
authors.lastname: Naderi Nabi
authors.affiliation: Anesthesiology Department, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Farnoush
authors.initials: F
authors.lastname: Farzi
authors.affiliation: Anesthesiology Department, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Hadi
authors.initials: H
authors.lastname: Atamanesh
authors.affiliation: Cardiac Surgery Department, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Nassir
authors.initials: N
authors.lastname: Nassiri
keywords: Cardiac Surgery; Diclofenac; Morphine; Pain