Clinical Study Of Morphine Combined With Oxycodone For Intravenous Patient-controlled Analgesia After Laparotomy Surgery

ObjectiveThe goal of this study was to investigates the efficacy and safety of morphine combined with oxycodone for intravenous patient-controlled analgesia(IV-PCA)after laparotomy surgery.MethodsThis study included 90 paitents who scheduled to undergo laparotomy with general anesthesia in Shandong Cancer Hospital affiliated to Shandong University from Jan 2017 to Aug 2018 with an age range of 30-70 years and ASA ?-?.A computergenerated randomization table was used to divide patients into 3 groups,30 cases in each group.The PCA protocols were 0.7 mg/kg oxycodone in GroupO,0.7 mg/kg morphine in GroupM,0.35mg/kg morphine combined with 0.35 mg/kg oxycodone in Group OM.Dilute them with 0.9% saline to 100 mL with the background dose of 2mL/h,patient-controlled analgesia 1mL per time,with an interval of 15 min.Pain severity,Ramsay sedation score,side effects and respiration rate(RR)were recorded 0.5 hours,3 hours,6 hours,12 hours,24 hours and 48 hours after the surgery.Cumulative opioid requirements and satisfaction with pain control were also measured.ResultsThe cumulative consumption of opioids in Group OM(46.71 ± 7.86mg)were significantly lower than that in Group O(52.71±4.94mg)and Group M(52.03±6.03mg)(P<0.001).Numeric rating scores decreased at 6 hours,12 hours,24 hours and 48 hours at rest and during movement in Group OM compared with Group O and Group M(P<0.001).Three patients in Group OM,10 atients in Group O and 18 patients in Group M reported adverse events,the difference is statistically significant(?2=16.92,P<0.001).Satisfaction with pain control in group OM was significantly higher than both in Group O and Group M(Group O: Satisfied,severe 20;Group M : Satisfied,severe 19;Group OM : Satisfied,severe 29)(?2=12.25,P=0.002).There was no significant difference in respiratory rate and Ramsay score among the three groups at different time points after operation(P > 0.05).ConclusionThe combination of morphine and oxycodone for PCA after laparotomy surgery can reduce the consumption of opioids,improve patient satisfaction,and provide better analgesia with fewer side effects compared with PCA with oxycodone or morphine alone.