Comparison of the effects of intraoperative morphine, fentanyl or paracetamol administration on postoperative pain level and analgesic consumption in patients with synchronous intraoprative remifentanil infusion

Abstract

Objective: We aimed to compare the effects of morphine, fentanyl or paracetamol applied for anesthesia induction and at the end of the surgery for postoperative pain control and analgesic consumption in patients who have undergone pelvic and lower abdominal surgery. Material and Methods: Patients with the American Society of Anesthesiologists (ASA) score I-II and aged between 18-70 years were given intravenous remifentanil intraoperatively. Fentanyl was administered in doses of 1.5 mcg / kg during anesthesia induction and 10 min before the end of the surgery. In fentanyl group, morphine was administered in doses of 0.1 mg / kg during induction and 0.5 mg/kg 30 min before the end of the surgery and paracetamol was administered in doses of 10 mg/kg during induction and 5 mg/kg 30 min before the end of the surgery. Morphine was administered for patient-controlled analgesia. Results: The mean verbal pain scores of the paracetamol group were significantly higher when compared to the pain scores of the other groups at the 0, 1, 2, 3, 4, 8, 12, and 16 hours (p <0.01, p = 0.02). Postoperative morphine consumption in the paracetamol group was significantly higher (p = 0.02). Conclusion: The addition of intraoperative paracetamol to the remifentanil infusion, may not be sufficient in postoperative analgesia in gynecologic cancer surgery.