Objectives: To investigate the effects of morphine and methadone for pain control after orthopedic surgery in patients addicted to opioids.
Research Design: A randomized, double-blind, clinical trial
Inclusion criteria: Opium -addicted patients, aged of 18-70 years undergoing major orthopedic surgeries. Exclusion criteria: Patients with a history of myocardial infarction, heart failure, patients with ASA above III, using anti-depressant, allergy to the drugs and patients requiring ICU after surgery.68 Patients are randomly divided into two groups MTD (methadone) and M (morphine).However,0.15 mg/kg morphine or methadone given to the patient an hour before the completion of the surgery. Patients in recovery room were treated according to the severity of pain as follows: morphine 1 mg every 5 minutes with pain score 6-4, and 2 mg every 5 minutes with pain score of 10 -7.While, blood pressure and breathing were monitoring, until the pain intensity reaches to less than 4. In the surgery ward morphine pump was used for patients in the both groups, as follows ,a solution of 20 cc, 0.5 mg per/cc with 1 mg or 2 CC bolus and interval locked out seven minutes and the maximum dose of 25 mg or 50 cc every 4 hours.At 0, 1, 3, 6 and 24 hours after surgery pain parameters (both in the time of the rest and activity), pruritus, nausea and vomiting, urinary retention, sedation and degree of patient satisfaction measured and data were recorded in a special form.
Pain Score, patient satisfaction and degree of sedation were measured via NRS, four point categorical scale and Wilson, respectively.