ABSTRACT

Background & objective: Pain management after surgery, by opioids and their side effects, still is an unresolved issue in medical sciences. Excessive use of drugs reduces respiratory rate, decreases blood pressure and oxygen consumption and increases temperature after surgery. These factors will lead to delayed patient recovery time. Therefore, the use of different methods of analgesia and control of its side effects is important. The researchers tried to investigate the hemodynamic changes in two methods of patients self injection and intramuscular injection after abdominal surgery.

Methods: This clinical trial was performed in Ahvaz Amyralmonin hospital at 2008 on 60 patients which were randomly divided into two equal groups: intramuscular injection (30 patients) and patient controlled analgesia group (30 patients). For pain control in intramuscular injection group 50 mg pethidine with IV placebo and in pain control by patients’ group through the venous pump 0.1 m/ kg / h pethidine in 50 cc normal saline 0.1% with 2cc/ h speed infusion was injected. Vital signs, including temperature, respiration, pulse, blood pressure, systolic and diastolic blood pressure immediately after injection and 6,12,18,24h after injection was registered by researcher and nurses and were analyzed by repeated measures, mauchly and Green house-Geisser test and analyzed using SPSS v.16.

Results: Comparison of hemodynamic variations between the two groups in systolic blood pressure (P <0.01), diastolic blood pressure (P <0.01) and pulse (P <0.04) indicated significant differences. Hemodynamic changes caused by narcotic drug’s side effects in pain control by patient group was lower. 

Conclusion: For better pain reliefe, narcotic drugs can be injected at short intervals and with newer techniques such as PCA pumps by patients. This method because of reducing opioid usage has lesser side effects. Therefore using venous pump by patients for pain control is better than traditional IV injection and all of health care centers containing surgical wards can replace newer methods with traditional ones.

Keywords: Hemodynamic, Pain, Patient, Intramuscular injections, Abdominal surgery