Comparison of the Analgesic Effect of Sufentanil and Morphine in Patient Controlled Analgesia Method after Coronary Artery by Pass Surgery

Introduction & Postoperative adequate analgesia decreases complications, hospital staying and cost. Postoperative pain management is very difficult and important. There are different techniques for it. One of these methods is patient controlled analgesia (PCA). The aim of this study is the comparison of analgesic and side effects of Morphine, Sufentanil and Placebo in PCA method. In this prospective randomized double-blind placebo controlled clinical trial 120 patients who had undergone CABG were divided in to three groups randomly. All of them were anesthetized with the same standard method and were extubated in post cardiac surgery intensive care. A basal infusion rate of 4cc/h was started intraoperativly before closing the sternum by Morphine0.3mg/kg/100cc for group M, Sufentanil 0.015mic/kg/100cc for group S, 0.2 mg /kg Morphine/15minute for group C. After tracheal extubation at ICU, PCA was started by Morphine0.3mg/kg/100cc for M group, Sufentanil 0.015mic/kg/100cc for S group an d normal saline at the same volume for C grouped with PCA bolus dose one milliliter, 15 minute lockout interval and basal infusion rate of 4cc/h, with auto infusion PCA pump (GMbH-WZ-6523C-8). The pain was evaluated (0-10) by visual analogue scale (VAS). Statistical analysis was done by Tukey-HSD test and means of analysis variance ANOVA was at 1 hour, 6h, 12h, 18h and 24 hours after tracheal extubation. VAS was significantly different between the control group and the other two groups at all times (P< 0.0001), but there were no significant statistical difference between Morphine and Sufentanil group. Although PCA is very successful and safe in control of post CABG surgery pain, but either Morphine or Sufentanil could sufficiently decrease post operative pain with no significant difference.