Patient-controlled analgesia - Comparison of morphine to Dexmedetomidine plus morphine in patients undergoing laminectomy

WOS: 000258715700005The aim of this study was to compare the analgesic effect of patient-controlled morphine with that of patient-controlled morphine plus dexmedetomidine oil postoperative pain in patients undergoing laminectomy. Ethics committee of the institute approved this Study. and after a written informed consent obtained from each participant, 64 patients with American Society of Anesthesiologist physical status I and II, scheduled for laminectomy were recruited for this prospective, randomized controlled Study. A standardized load morphine dose of 0.15 mg/kg was given to all patients. Patients were randomized into 2 groups postoperatively. The settings were IV morphine, bolus dose 0.02mg/kg, with a lock out time of 15 minutes in group morphine (n = 32). The settings were bolus dose 0.02 mg/kg and 0.1 mu g/k dexmedetomidine with a lock out time of 15 minutes in group morphine Plus dexmedetomidine (n = 32). Hemodynamic variables, pain scores, and sedation scores were recorded postoperatively. No differences were detected in the demographic data, hemodynamic variables, and pain scores. Total morphine consumption was 46.37 +/- 12.05 mg in group morphine and 16.03 +/- 8.55 mg in group morphine plus dexmedetomidine. Sedation scores were significantly higher ill group morphine plus dexmedetomidine after the first hour. Using morphine or morphine plus dexmedetomidine in patient-controlled analgesia provided effective postoperative analgesia. In the morphine plus dexmedetomidine group, postoperative morphine consumption was lesser than that of the group with only morphine. This result may be explained as a synergistic effect of dexmedetomidine with the analgesic action of morphine

The relationship between somatic sense perception levels and comorbid psychiatric diseases in chronic pain patients

WOS: 000496919400004PubMed ID: 31741346Objectives:The purpose of the study was to evaluate any comorbid psychiatric disorders in patients with chronic pain and to examine the effects of sociodemographic details and the level of somatic sense perception on the severity of these diseases. Methods: In this study, 51 chronic pain patients were evaluated in a consultation with a psychiatrist. Sociodemographic characteristics of the patients, such as age, gender, education level, and marital status were recorded, and Structured Clinical Interview for DSM-IV results were assessed.The patients'chronic pains were classified as idiopathic or secondary to organic etiology. In addition, the Symptom Checklist-90, Somatosensory Amplification Scale (SSAS), Hamilton Depression Rating Scale, and the Hamilton Anxiety Scale (HAM-A) were used. Results: The incidence of psychiatric disorders in chronic pain patients was found to be 74.5%. Somatoform disorders were the most frequently diagnosed, at 37.3%. The rate of depressive and anxiety disorders was, respectively, 29.4% and 23.5%. Comorbid anxiety scores (p=0.019) and SSAS scores (p=0.046) were significantly higher in chronic pain patients with a somatoform disorder. HAM-A scores were found to be significantly higher in patients with depression (p=0.004). A positive and linear relationship was determined between the SSAS score and depression, anxiety, and the severity of mental symptoms. Conclusion: Structured or semi-structured interviews can be performed in pain polyclinics or psychiatric outpatient clinics to determine the level of perception of somatic sensations. This could be beneficial in the treatment of chronic pain and comorbid psychiatric disorders