A Comparison of Sedative & Hemodynamic Effects of Morphine and Remifentanil in Traumatic Patients Requiring Mechanical Ventilation in Intensive Care Unit

Patients admitted to intensive care units require sedation. The usual drugs for this issue include benzodiazepines, opioids, barbiturates, and hypnotics. This study was conducted to compare the sedative and hemodynamic effects of morphine and remifentanil in traumatized patients requiring intubation and mechanical ventilation in intensive care unit during the years 2003-4. Patients & This study was performed as a randomized controlled clinical trial at the surgical intensive care unit. 60 patients with an age range of 18-80 were enrolled in this study. The patients were randomly categorized into morphine and remifentanil groups. The first group was given a 5 mg bolus dose of morphine and the second group received an infusion of remifentanil starting with 0.05µg/kg and the doses were sequentially increased to reach a sedation state of 3-4 according to Ramsey scale. The regimen was continued as maintenance for 24 hours, during which blood pressure, heart rate, and respiratory rate was monitored every 4 hours. Data was analyzed using SPSS software. A total number of 60 patients aged 18-80 yrs(mean age of 42.53±18.5 yrs) consisting of 37(61.7%) male and 23(38.3%) female were equally categorized into two groups. The mean blood pressure of the morphine group was 109.12±1.68mmHg and that for the remifentanil group was 90.01±6.66(P<0.00). The mean heart rate of the aforementioned groups were 101.89±2.31 and 95.06±10.15(P<0.00) and the mean respiratory rate was 19.95±2.49 and 19.24±4.37(P<0.4) respectively. Although remifentanil induced an initial decline of blood pressure, it maintained the pressure in a rather steady state during the period of infusion(24 hours) compared with that of morphine. Therefore, in situations in which an initial decline of blood pressure is not considered a threat, remifentanil provides a more stable condition for the patients.