| Learning Objective #1: Compare the basic pharmacokinetic action of morphine and fentanyl | |||
| Learning Objective #2: Propose a postoperative pain management protocol for cardiac surgery patients based on preliminary evidence |
Objective: The purpose is to compare the effectiveness of morphine and fentanyl for postoperative pain management in cardiac surgery patients. Design: Randomized experimental. Population, Sample, Setting, Years: 200 non-emergent adult patients in a 616-bed tertiary care center with 1400 cardiac surgeries annually. Sample size based on a median difference of 0.7. Data will be collected from December 2002 until sample size attained. Fifty subjects have been completed in one month. Intervention and Outcomes Variable: Intervention includes peri-operative teaching of the 0-10 pain scale and randomization to Morphine or Fentanyl PCA immediately postoperative, followed by protocol order for oral pain medications. Outcome variable is pain; the primary nurse assesses pain behaviors until subjects able to self-report. Pain level expectations, tolerance, and pain relief are documented daily. Methods: Following consent, subjects are randomized to Morphine or Fentanyl PCA. Pain scores during rest and activity are assessed and recorded twice daily for four days. For patients who cannot self-report, pain behaviors as recorded by the primary nurse. The amount of pain medication received is totaled and converted for comparison, using an equianalgesic table. Findings: Results will be analyzed using repeated measures ANOVA, student t-test, and non-parametric statistics as appropriate. It is anticipated that results will be available by November 2003. Implications: Cardiac surgery is one of the most frequently performed surgical procedures worldwide. Management of a patient's postoperative pain is of paramount importance for physiological and psychological reasons. In 2002, our pain audit data showed a self-reported decrease in satisfaction with pain management following a protocol change from Morphine to Fentanyl postoperatively. This study is designed to answer this important clinical question regarding pain management in this surgical population. It is not known if there are age or gender differences in response to these commonly used narcotics.
Back to Interventions for Pain
Back to 37th Biennial Convention - Scientific Session
Sigma Theta Tau International