The effect of peroperatively and postoperatively used parasetamol on postoperative morphine consumption in spinal surgery [Spinal cerrahide peroperatif ve postoperatif kullanilan i·ntravenöz parasetamolün postoperatif morfin tüketimine etkisi]

Aim: The aim of this study is to investigate the effects of iv paracetamol with iv morphine PCA on postoperative morphine consumption in lumbar disc surgery. Materials and Methods: After obtaining the approval of the hospital ethics committee and patient's consents, 67 adult patients, in ASA group's I-III, were randomly divided into two groups. Group M (n=37) received iv morphine Patient Control Analgesia (PCA) postoperatively (bolus dose 1 mg, lock out time 10 min, limited 50 mg 24 hrs-1). At the skin closure, iv paracetamol (1 g infused in 15 min, 8 g 48 hrs-1) was also administered with morphine PCA in Group MP. All the patients with Visual Analogue Scale (VAS) scores over 3 were administered iv morphine in fractioned doses at recovery room (0. minute). The systolic and diastolic arterial pressures, hearth rate, SpO2, breathing rate, PCA demand number, replied demand number and total morphine consumption, sedation scores, VAS scores, presence of nausea and vomiting, itching and patches were recorded at 0., 30., 60. min, 2., 4., 6., 12., 18., 24. and 48. hrs. Fractioned morphine amounts and antiemetic consumption were also recorded. Fractioned morphine amounts, total morphine consumption and sedation scores were found to be lowered in Group MP (p<.05). The difference between the total morphine consumption amounts of the study groups (76.4±6.7 mg in Group M and 42.5± 5.2 mg in Group MP) were significant (p<0.05). In addition, the VAS scores of Group M were found to be higher in the first two hours (p<0.05). Conclusion: It is concluded that the combination of iv paracetamol and morphine PCA after spinal surgery enhances the quality of the postoperative analgesic effect of morphine PCA by lowering the morphine consumption amount