Antiemetic and analgesic-sparing effects of diphenhydramine added to morphine intravenous patient-controlled analgesia.
Br J Anaesth
; 94(6): 835-9, 2005 Jun.
Article
en En
| MEDLINE
| ID: mdl-15833782
ABSTRACT
BACKGROUND:
This study was designed to examine the analgesic and dose-related antiemetic efficacy of diphenhydramine-morphine mixture for intravenous patient-controlled analgesia (PCA).METHODS:
Healthy women, undergoing abdominal total hysterectomy were recruited to this double-blinded randomized placebo-controlled study. Patients were randomly allocated to one of three groups (n=40 each). In group 1, patients received saline at induction and morphine 1 mg ml(-1) alone for postoperative PCA. Patients in groups 2 and 3 received diphenhydramine 30 mg i.v. at induction and were given a 1.21 or a 4.81 ratio, respectively, of diphenhydramine-morphine mixture for postoperative PCA.RESULTS:
A total of 112 patients completed the study. The incidence of postoperative nausea (31.6% vs 67.6%, P<0.01) and vomiting (15.8% vs 40.5%, <0.05) was significantly lower in group 3 than in group 1. Furthermore, the incidence of severe nausea was significantly lower in group 3 than in group 1 (2.6% vs 24.3%, P<0.05). The rescue antiemetic requirements were also significantly less in group 3 than in group 1 (5.3% vs 24.3%, P<0.05). However, there was no significant difference between group 2 and group 1 in any of the comparisons. Pain intensity, 24-h morphine consumption and diphenhydramine-related side-effects, such as sedation or dry mouth, did not differ among the three groups.CONCLUSION:
An initial bolus of diphenhydramine 30 mg at anaesthetic induction followed by postoperative PCA with a 4.81, but not 1.21, diphenhydramine-morphine mixture provides an effective antiemetic efficacy without morphine-sparing effects.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Analgesia Controlada por el Paciente
/
Difenhidramina
/
Analgésicos Opioides
/
Morfina
/
Antieméticos
Tipo de estudio:
Clinical_trials
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
Br J Anaesth
Año:
2005
Tipo del documento:
Article
País de afiliación:
Taiwán