Comparison of intravenous morphine with intraperitoneal bupivacaine for reduction of post operative pain

Abdominal surgery is one of the most painful operations. This postoperative pain may cause different side effects such as tachycardia and cardiac ischemia. Transabdominal hysterectomy is one of this kinds of surgery. Different kinds of medications and techniques have been utilized to manage this intense pain. Intravenous opioids are one of these modalities which causes known adverse sideffects. Other methods and procedures could be used such as infiltration of local anesthetics into the operation site. In this study, we compared intravenous morphine with intraperitoneal bupivacaine for reduction of post operative pain. 60 patients ASA Class I and II patients aged 35 to 55 years with BMI between 25 to 30 who had no anesthesia risk factor and had their operation done in 90 to 150 minutes, were randomly divided into two groups B (bupiva-caine) and M (morphine). At the end of surgery, 0.1 mg/kg intravenous morphine sulfate and 40 ml of intraperitoneal sterile normal saline injected for group M and 0.1 ml/kg of intravenous saline and 40 ml of 0.25% intraperitoneal bupivacaine injected for group B. The pain score (VAS) Visual Analog Scale, the first demand for analgesics and total amount of analgesic used for each group, were compared. There were no statistically significant demographic differences between two groups. Intravenous morphine used to keep pain score below 3 was much less in group M and group B patients demanded for analgesics much sooner which were statistically meaningful. Since the hemodynamic status of two groups were not in the same range before intervention, the differences in hemodynamic status after intervention could not be reliable. Intraperitoneal bupivacaine at the dose of 40 ml of 0.25% and in transabdominal hysterectomy, could not provide ample analgesic effect.