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Pain following craniotomy: a preliminary study comparing PCA morphine with intramuscular codeine phosphate
M D Stoneham1, R Cooper, N F Quiney
1Department of Anaesthesia, Frenchay Hospital, Bristol.
Anaesthesia
|December 1, 1996
Summary
Patient-controlled analgesia (PCA) with morphine offers a comparable alternative to codeine phosphate for postoperative pain management in craniotomy patients. Further research is recommended for this neurosurgical pain relief option.
Area of Science:
- Neurosurgery
- Pain Management
- Pharmacology
Background:
- Effective postoperative pain management is crucial for patients undergoing craniotomy.
- Intramuscular codeine phosphate is a common analgesic choice.
- Patient-controlled analgesia (PCA) offers an alternative delivery method for pain medication.
Purpose of the Study:
- To compare the efficacy and safety of intramuscular codeine phosphate versus morphine PCA in patients following craniotomy.
- To assess postoperative pain, nausea, sedation, and respiratory status.
Main Methods:
- Prospective randomized trial involving 30 craniotomy patients.
- Comparison of intramuscular codeine phosphate with morphine PCA (1 mg bolus, 10-min lockout, no background infusion).
- Assessment of pain, nausea, Glasgow Coma Score, respiratory rate, and sedation for 24 hours postoperatively.
Main Results:
- Morphine consumption in PCA group varied widely (median 17 mg, range 2-79 mg).
- A small, non-significant reduction in pain scores was observed with PCA.
- No significant differences in nausea, vomiting, sedation, or respiratory rate between groups.
Conclusions:
- Morphine PCA is a viable alternative to intramuscular codeine phosphate for neurosurgical patients.
- Further investigation into PCA for neurosurgical pain management is warranted.