Comparison of Intravenous Morphine with Morphine Sulfate Suppository in Control of Pain after Knee and Hip Arthroplasty

A different forms of morphine (intravenous، oral، intramuscular) are used in control of pain after surgeries. Morphine Sulfate rectal suppository is a new form of this drug. The aim of this study was to compare the effect of morphine as two methods، intravenous morphine (Patient-Controlled Analgesia، PCA) and Morphine Sulfate rectal suppository in control of postoperative pain. In a double-blind controlled clinical trial، 60 patients (18-65 years old) undergoing hip or knee arthroplasty enrolled in this study. They were randomly divided into two groups: A and B. Group A received intravenous morphine (PCA) while the second group received rectal morphine suppository (10mg). Pain intensity assessed by using visual analogue scale (VAS) and verbal pain score. Data was collected using the questionnaire. The prepared questionnaire is used for evaluation of patient satisfaction (completely satisfied، satisfied، no comments، dissatisfied، completely dissatisfied). The number of nausea and vomiting، drowsiness and hamodynamic variables were also evaluated and compared. Mean of pain intensity after 24 hours in PCA group (1. 50±0. 97) in compared to morphine suppository group (1. 57±1. 33) was not significantly different. So in group A، 56. 7% was completely satisfied in compared to 48. 3% in group B (p=0. 3). Nausea and vomiting occurred in 5 patients in group B (16. 7%) but in group A any patient did not have nausea and vomiting (p=0. 026). In this study، postoperative pain was controlled similar in two groups. Although، postoperative nausea and vomiting was more common in suppository group.