Analgesic Efficacy of Interpleurally Administered Morphine and Fentanyl After Posterolateral Thoracotomy

authors:

avatar Shideh Dabir 1 , * , avatar Tahereh Parsa 1 , avatar Badiozaman Radpay 1 , avatar Saviz Pozhhan 1 , avatar Ali Akbar Khadem Maboudi 2 , avatar Mohammad Abbasi-nazari 3 , avatar Jamshid Salamzadeh 3

National Research Institute of Tuberculosis and Lung Disease, Dr. Masih Daneshvari Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
Department of Biostatistics, School of Paramedical Sciences, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
Department of Clinical Pharmacy, Shaheed Beheshti University of Medical Sciences, Tehran, Iran

how to cite: Dabir S, Parsa T, Radpay B, Pozhhan S, Khadem Maboudi A A, et al. Analgesic Efficacy of Interpleurally Administered Morphine and Fentanyl After Posterolateral Thoracotomy. Iran J Pharm Res. 2007;6(1):e128310. https://doi.org/10.22037/ijpr.2010.699.

Abstract

Pain control is a major concern in post-thoracotomy patients. The current prospective randomized double-blind study was designed to evaluate the analgesic effects of morphine and fentanyl given interpleurally after posterolateral thoracotomy. Thirty patients undergoing elective posterolateral thoracotomy in a teaching hospital in Tehran were divided into 3 groups with equal number of patients. Patients in group IPM, IPF1 and IPF2 received 0.1 mg/kg morphine sulfate, 5 µg/kg fentanyl and 2.5 µg/kg fentanyl in a total volume of 40 ml injected via an intrapleural catheter placed in the pleural space before the closure of chest. Subsequent doses of interpleural injections were administered at 4 and 8 h after operation. The intensity of pain was evaluated at rest and with coughing just before each interpleural injection and 30 min afterwards using a 10 point visual analogue scale (VAS). If patients needed additional analgesia, indomethacin suppository and intravenous morphine were given during the 20-h postoperative study period. In all of the 3 study groups VAS scores were significantly reduced 30 min after interpleural administration of the study solutions (p<0.05). However, inter-group comparisons revealed no significant differences for VSA scores, supplemental analgesic usage and systemic side effects. Briefly, interpleural morphine and fentanyl following thoracotomy produce equal analgesia without major side effects.