مقایسه اثر مرفین اینترپلورال و مرفین وریدی بر درد پس از جراحی از طریق ویدئو توراکوسکوپی

Abstract Background and purpose: Video-assisted thoracoscopic surgery (VATS) has been developed as a minimally invasive alternative approach for various diagnostic and therapeutic thoracic operations that previously required open thoracotomy. Postoperative pain is less after VATS than after conventional thoracic surgery, yet its relief is still important. The purpose of this randomized double blind clinical trial was to compare the effect of interpleural morphine analgesia with traditional intravenous morphine administration on pain and supplemental analgesic usage after VATS. Materials and methods: Thirty patients of class I and II of American Society of Anesthesiologists when underwent VATS under general anesthesia were randomly divided into two equal groups. By the end of the operation, a catheter was placed in the pleural space under thoracoscopic vision. Patients received a single bolus of 0.1 mg•kg-1 of morphine either interpleurally or intravenously. During the first 8 hours after operation, pain score at rest and on coughing, supplemental analgesic requirements, mean arterial pressure, heart rate, arterial blood oxygen saturation, degree of sedation, and side effects were monitored every hour. The pain severity was evaluated by visual analogue pain scales (VAS, 0-10). Results: No statistically significant difference was observed between the groups in relation to pain intensity, hemodynamic variables, or side effects during the study. Conclusion: Interpleural morphine did not provide superior analgesia compared with intravenous morphine after thoracoscopic surgery.