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Submit Date 2019-01-19 Revise Date 2019-03-14 Accept Date 2019-03-15 ABSTRACT Background: morphine is a potent analgesic in decreasing postoperative pain; however its use is accompanied by many complications especially respiratory one. On the other side, fentanyl titration may cause less postoperative respiratory complications. Objective: To compare between intravenous long-acting opioid (Morphine), and short-acting opioid (Fentanyl) regarding postoperative hypoxemia after non-cardiac surgery. Patients and methods: A prospective randomized clinical study done on 52 patients, they were divided equally into two groups: Group M (Morphine) received (0.1mg/kg), and Group F (Fentanyl) received (1ug/kg) on induction, and supplemented by effective rescue analgesia. When postoperative VAS score ≥4 , patients in Group M received 5mg morphine as bolus ,and reassess pain every 5 min to give another bolus ( the total allowed dose was 15mg/3-4h).For Group F 50ug fentanyl was given as a bolus ,and could be repeated (total allowed dose was 100 ug/1-2h.). Result(s): There were no significant difference between two groups as regard respiratory rate (RR) nor peripheral O2 saturation (SPO2) (P value<0.05), however there were significant higher RR at 44 hrs and 48hrs in fentanyl group, and higher SPO2 at 5 min.,28h, and 40h compared to morphine group. VAS score showed no significant difference between two groups, however fentanyl group show significant high VAS score at the first three hours. Nausea, vomiting, and itching show significant increase in morphine group compared to fentanyl group (P value>0.05). Conclusion: Intravenous morphine as effective rescue analgesic is not associated with more postoperative hypoxemia, or respiratory depression than fentanyl.

zagazig university medical journal

IS INTRAVENOUS LONG-ACTING OPIOID (MORPHINE) ASSOCIATED WITH MORE POSTOPERATIVE HYPOXEMIA THAN SHORT-ACTING OPIOID (FENTANYL) AFTER NON-CARDIAC SURGERY?