Title: Comparing The Effect Of Ketorolac and Morphine With Morphine Alone in Postoperative Pain Management of Obese Patient Undergoing Gastric Bypass Surgery.

1- Determination of effect of Ketorolac and Morphine with Morphine alone in number needed to treat in postoperative pain management of obese patient undergoing gastric bypass surgery in Iranmehr hospital in 1396 2-Determination of effect of Ketorolac and Morphine with Morphine alone in pain score of 6th hour after surgery of obese patient undergoing gastric bypass surgery in Iranmehr hospital in 1396

Sample size was 34 in each group due to Repeated Measure method (6 repeat) with G-Power statistical software. Type 1 error and statistical power was 0.05 and 95%. Participants are allocated in two groups by permuted block randomization method. Also Allocation concealment will be ensured, by assigning 5 digit code to participants in each group by a person who is not aware of hypothesis. Surgical and anesthetic plan was the same for two groups. Control group received patient control analgesia (PCA) with infusion of 0.8 mg morphine sulfate per hour and intervention group received PCA with infusion of 0.4 mg morphine sulfate plus 30 mg IV and 30 mg IM ketorolac and also 15 mg ketorolac IM each 6 hour. Pain in both group was evaluated by Visual Analogue Scale (VAS). At the time of entering ward, and 6, 12 and 24 hour after admission to ward VAS was measured. Dose of Acetaminophen and ondansetron used for each group also recorded.

This study was conducted in Iranmehr Hospital under supervision of anesthesiologist. In this study, due to intramuscular injection of ketorolac, participants and nurses in the operating room are not blinded. On the other hand data collector and outcome assessors will be blinded to the group of participants.

Inclusion Criteria BMI>40 BMI>35 with complications ASA I & II Exclusion Criteria ASA >III Any changes in anesthesia or surgical plan Any history of addiction or substance abuse Any history of allergic reaction to drugs using in the study

Control group received patient control analgesia (PCA) with infusion of 0.8 mg morphine sulfate per hour and intervention group received PCA with infusion of 0.4 mg morphine sulfate plus 30 mg IV and 30 mg IM ketorolac and also 15 mg ketorolac IM each 6 hour. Both of them in addition to the described regiment, will receive 1 gr of acetaminophen intravascular each 12 hour.

Pain score by VAS score Number needed to treat

Shahid Beheshti Medical University

Participants are allocated in two groups by permuted block randomization method which the block size was assumed four. Also Allocation concealment will be ensured, by central telephone method and assigning 5 digit code to participants in each group by a person who is not aware of hypothesis.

In this study, nurses in the operating room are not blinded. On the other hand data collector and outcome assessors will be blinded to the group of participants. Patient is blind to the group they are in.