Saad Eddin Adnan, Selim Hazem, Suleiman Roaa, Thomas Jeena
Department of Anesthesiology, Hamad Medical Corporation, Doha, Qatar*Correspondence: Adnan Saad Eddin. Email:
Qatar Med J. 2025 Feb 23;2025(1):7. doi: 10.5339/qmj.2025.7. eCollection 2025.
Postoperative pain management is crucial for recovery from surgery. Patient-controlled analgesia (PCA) with morphine and fentanyl are commonly used, but their comparative efficacy remains uncertain. This study aims to evaluate opioid consumption and pain control in patients receiving PCA morphine versus PCA fentanyl after colorectal surgery.
A retrospective analysis of adult patients undergoing elective colorectal surgery was conducted. Patients were divided into two groups based on PCA morphine or PCA fentanyl use. Outcomes measured were opioid consumption in morphine equivalents, numerical pain scores expressed as Numerical Rating Scale (NRS), patient demand, and side effects within the first 48 hours postoperatively.
Of 370 patients screened, 152 met the inclusion criteria. No significant differences were found in total opioid consumption (median: 38 vs. 28.5 mg, = 0.095), patient demand (median: 46.5 vs. 35, = 0.156), or NRS (median: 4 vs. 3.5, = 0.348). Side effects were comparable between groups. Subgroup analysis revealed higher opioid consumption and demand in females taking fentanyl compared to morphine. Age was negatively correlated with pain-related outcomes, and smokers showed higher opioid consumption and higher pain scores.
PCA morphine and fentanyl provide similar postoperative pain relief in colorectal surgery patients, with no significant differences in opioid consumption or side effects. Female patients may respond better to morphine, and age and smoking status significantly influence pain management outcomes. Further prospective studies are recommended to better define these findings and inform postoperative pain strategies.
术后疼痛管理对手术恢复至关重要。吗啡和芬太尼的患者自控镇痛（PCA）是常用方法，但其相对疗效仍不确定。本研究旨在评估结直肠手术后接受PCA吗啡与PCA芬太尼治疗的患者的阿片类药物消耗量和疼痛控制情况。
对接受择期结直肠手术的成年患者进行回顾性分析。根据使用PCA吗啡或PCA芬太尼将患者分为两组。测量的结果包括术后48小时内以吗啡当量表示的阿片类药物消耗量、以数字评分量表（NRS）表示的数字疼痛评分、患者需求以及副作用。
在筛查的370例患者中，152例符合纳入标准。在总阿片类药物消耗量（中位数：38 vs. 28.5 mg，P = 0.095）、患者需求（中位数：46.5 vs. 35，P = 0.156）或NRS（中位数：4 vs. 3.5，P = 0.348）方面未发现显著差异。两组之间的副作用相当。亚组分析显示，与吗啡相比，服用芬太尼的女性阿片类药物消耗量和需求更高。年龄与疼痛相关结果呈负相关，吸烟者的阿片类药物消耗量和疼痛评分更高。
PCA吗啡和芬太尼在结直肠手术患者中提供相似的术后疼痛缓解，在阿片类药物消耗量或副作用方面无显著差异。女性患者可能对吗啡反应更好，年龄和吸烟状况显著影响疼痛管理结果。建议进一步进行前瞻性研究，以更好地明确这些发现并为术后疼痛策略提供依据。
