Comparative study of the analgesic effect of Morphine patient control analgesia pumps and Fentanyl Trans-dermal patches in acute post operative pain management in addicted patients

With the aim of comparison of the analgesic effect of Morphine pumps and Fentanyl patches in acute post operative pain control, we will enroll 300 patients (150 addict patient and 150 non addict patient), aged between 15 to 60 years old which have been undergone orthopedic surgeries in Shahid Kamyab accident hospital in 2013 to 2014 in this study. After filling the inclusion criteria such as age, head trauma or unconsciousness, they are fully informed and sign the ethical committee forms. Based on the type of surgery (major, minor and moderate), patients will be randomly divided into two groups, for post operation pain control: in group A, patients will receive IV- Morphine PCA pump. Each pump is filled by 20 mg Morphine diluted in 100 cc normal saline and is set in 1mg/h infusion rate. One bolus dose could be added by the patient if he/she felt undesirable pain. In group B Fentanyl transdermal patches with total dose of 25 μg are used. Regarding the delay action of the patches, they are attached upon the patients arm 18 h before the operation. Duration and type of drug addiction history by a trained research nurse was not involved in the treatment process will be recorded. The severity of the pain will be registered according to Visual Analogue Scale in specially designed forms by pain-trained nurses in two steps, first after the surgery and before the beginning of analgesic effect; no other analgesic drug will be used at this time. So 24 h after the surgery pain will be assessed again.

Orthopeadic Research Center and Vice chancellor for research Mashhad University of Medical Sciences