Comparison of the Effects of Morphine and Diltiazem on Blood Pressure and Heart Rate during Craniotomy Surgeries

Getting out of the anesthesia occurs with stimulation of sympathetic system and increasing in patient's pulse and blood pressure. Various methods are used to control the blood pressure and heart rate, but there is no single method, so far. This study aimed to compare the effects of morphine and diltiazem of blood pressure and pulse rate in recovery time among the patients underwent craniotomy. In a double-blind clinical trial study during 2012-2013, 60 patients who were candidates for craniotomy were selected and divided in two groups of 30. The first group received 60 mg diltiazem and the second group received 0.1 mg/kg morphine. During 4 hours after the surgery, the hemodynamic variables were checked and compared between the two groups. Before the operation, the mean systolic blood pressure was 120.6 ± 12.5 and 126.8 ± 18.7 mmHg in morphine and diltiazem groups, respectively (P = 0.560). 4 hours after the drug consumption, mean systolic blood pressure was 130.6 ± 13.2 and 100.4 ± 16.2 mmHg in morphine and diltiazem groups, respectively (P < 0.001). During the follow-up period in recovery room, there was no significant difference between the blood pressure and heart rate between the two groups; but 4 hours after the drug consumption, systolic and diastolic blood pressure was significantly lower in the diltiazem group. During the study, there was no significant difference in heart rates between the two groups. According to the results of the study, using diltiazem led to better control of blood pressure during craniotomy with little side effects. So, it can be used safely in patients under craniotomy.