The effect of paracetamol postoperative morphine consumption in application of preemptive and perioperative hip replacement

Purpose: Postoperative pain with emotional changes and hemodynamic instability are frequently observed problems in total hip replacement surgery. Patient Controlled Analgesia is also after used method in postoperative pain management. In this study, we aimed to determine the effect of postoperative morphine consumption in applying preemptive and perioperative paracetamol via i.v.Material and Methods: After approval of Faculty Ethical Commitee and patient consent, 60 patients who are applied total hip replacement surgery were included the study. Patients randomly divided into three groups. Group I were received preemptive 30mg/kg paracetamol in 15 minutes via i.v. infusion. Then, 0,2 mg/kg morphine was administered via i.v. bolus on 30 minutes before the end of operation. Group II were administered 30 mg/kg paracetamol via i.v. infusion on 45 minutes before the end of perioperative operation. Also, 0,2 mg/kg morphine was administered via i.v. bolus. Group III were received 0,2 mg/kg morphine via i.v. bolus on 30 minutes before the end of operation. Morphine (40 mg diluated with 100 cc SF, 0,02 mg/kg PCA, 15 minutes locked in time) infusion started with PCA for the all three groups and (4 mg) ondansetron was administered via i.v. Postoperative systolic and diastolic blood pressures, heart rate, O2 saturation values, VAS scores, PCA morphine total doses and posible side effects were recorded.Results: Demografic data, operation times and hemodynamic parameters of groups were similar. Total morphine consumption was recorded in 24 hours for group I was 11,8±8,6 mg, group II was 18,20±10,9 mg, group III was 23,40± 11,2 mg.Morphine consumption of group III was statisically higher than group I. However there were not any significantly difference in side effects between the groups.Conclusions: We concluded that single dose preemptive paracetamol management reduce postoperative morphine consumption without side effects in total hip replacement surgery.Key Words:Patient Controlled Analgesia, Morphine, Preemptive Analgesia, Paracetamol, Total Hip Replacement.