Comparison of the Postoperative Analgesic Effects of Morphine, Paracetamol and Ketorolac in Patient-Controlled Analgesia (PCA) in Patients undergoing Open Cholecystectomy

Objectives: Effective post-operative pain management in abdominal surgeries which are painful procedures, plays an important role in reducing post-operative complications and increasing patient's satisfaction. There are many techniques for pain control, one of which is patient-controlled analgesia (PCA). The aim of this study was to compare the analgesic effects of morphine, paracetamol and ketorolac in patients undergoing open cholecystectomy, using PCA method. Design: Randomized controlled trial Setting: Department of anesthesiology, Shahid Rajaee Hospital, Qazvin, Iran Subjects: Three hundred and thirty ASA (American Society of Anesthesiology) I-II patients (three equal groups of n = 110) who were scheduled for elective open cholecystectomy. Intervention: The control group received morphine with maximum dose of 0.02 mg/kg/h, the paracetamol group received paracetamol with maximum dose of 1 mg/kg/h, and the ketorolac group received ketorolac with maximum daily dose of 60 mg using IV-PCA method. Main outcome measure: Post-operative pain Results: There were no significant differences in demographic data between the three groups. There was a statistically significant difference with regard to the mean pain score at all times between morphine and paracetamol, morphine and ketorolac, and paracetamol and ketorolac groups (p < 0.001). The mean level of pain in ketorolac group was less than that in the other two groups (p < 0.001) at all times. Conclusion: According to the results of this study, ketorolac is more effective than morphine and paracetamol in postoperative pain control.