Comparison of adding dexmedetomidine to ketorolac and morphine on pain control due to femoral fracture surgery

Abstract

Postoperative pain control plays an essential role in facilitating the patient's recovery to normal function and reduces the occurrence of adverse physiological and psychological effects associated with acute and uncontrolled pain. In recent years, many clinical trials have been conducted regarding the use of medicinal compounds along with opioid and non-opioid drugs to increase analgesia and reduce complications, and there is a need for further evaluation of the effectiveness of this method. This clinical trial was conducted with the aim of comparing the effectiveness of adding dexmedetomidine to ketorolac and morphine on pain control caused by femoral fracture surgery. Method: In the present study, 200 people over the age of 18 who were diagnosed with a femur fracture and underwent surgery at Imam Reza Hospital in Tabriz, with the aim of comparing the effectiveness of adding dexmedetomidine to ketorolac and morphine on pain control caused by fracture surgery. Patients were randomly assigned to one of 4 groups: "A" (dexmedetomidine + morphine), "B" (morphine), "C" (ketorolac + morphine) and "D" (ketorolac). Post-operative complications and pain intensity were recorded and compared using the VAS scale up to 24 hours after the operation. Results: All 200 patients were included in the final analysis. There was no significant difference between the groups in demographic variables, body mass index, ASA score and duration of surgery. Also, there was no significant difference in heart rate, arterial pressure and oxygen saturation in most of the times measured during the operation. The intensity of pain in groups "A" and "B" was significantly lower than the groups receiving ketorolac (p<0.05). Also, the heart rate drop once and twice was significantly higher in groups "A" and "C" than other groups (p<0.05). The total opioid drug required in groups "C" and "D" was significantly more than the first two groups (p<0.05). No significant difference was observed in the prescription of vasopressor, atropine and antinausea drugs between the groups.