Comparison of the Efficacy of Intravenous, Subcutaneous, and Suppository Morphine in Reducing Post Hysterectomy Pain

Background and aims: Postoperative pain has always been considered by surgeons because of its various complications. The aim of thisstudy was to compare the effect of intravenous, subcutaneous and suppository morphine in reducing post-hysterectomy pain.Materials and Methods: In this clinical trial, ۹۰ patients undergoing hysterectomy were randomized into three groups of ۳۰ each usingsimple randomization, namely, intravenous, subcutaneous, and suppository morphine (۱۰ mg). Before intervention and ۴, ۸, ۱۲, and ۱۶hours after intervention, pain intensity was measured using visual analogue scale (VAS). Relative frequency of nausea, vomiting, itching,bradypnea, and apnea in all groups was recorded. Data were analyzed by SPSS version۱۶.۰.Results: Mean pain severity at ۰ hour postoperatively (P=۰.۰۰۴), ۴ hours postoperatively (P=۰.۰۰۹), ۸ hours postoperatively (P=۰.۰۰۹), and۱۲ hours postoperatively (P=۰.۰۰۱) was significantly higher in the suppository morphine group than in the other two groups. There was nosignificant difference in pain severity at ۱۶ hours postoperatively among the three groups (P=۰.۴۴۶). According to the results of repeatedmeasures ANOVA, changes in pain severity at the five intervals were statistically significant in all three groups (subcutaneous, intravenous,and suppository morphine groups) (P<۰.۰۰۱). There was also a statistically significant difference in pain severity at the studied intervalsamong the three groups (P<۰.۰۰۱). The frequency of nausea (P=۰.۰۵) and vomiting (P=۰.۸۴) was higher in the suppository group than inthe other two groups, although the difference was not statistically significant (P=۰.۰۵).Conclusion: The results of this study indicated better efficacy of subcutaneous and intravenous morphine in reducing post-hysterectomypain compared with suppository morphine.

Keywords:

Morphine , Hysterectomy , Pain