Comparison of morphine-midazolam versus morphine injection for pain relief in patients with limb fractures - a clinical trial.

Abstract

BACKGROUND:

Pain relief, using opiates as a primary choice, is an important part of treating limb fractures. Yet, in order to reduce opiate consumption, other combinations have been introduced. This study aimed to compare pain reduction by a combination of morphine-midazolam with morphine injection in patients with limb fractures.

METHODS:

A randomized double-blind study of patients with upper or lower extremity fractures was conducted. Patients' response to treatment with either morphine-midazolam solution or morphine at 15, 30, 45, 60, 120, and 180 minutes were assessed. The Kaplan-Meier curves and generalized estimating equations were examined to evaluate the success of treatment.

RESULTS:

A total of seventy-two patients aged 18-60 (80.6% male; mean age: 35±17.9 years) were included. At 15, 30, 45, and 60 minutes, successful pain control was seen in 8.83 22.2%, 33.3% and 63.9% of the patients in the morphine group, and 11.1%, 27.7%, 44.4% and 63.8% in the midazolam-morphine group. By the third hour, pain-control was achieved in all patients receiving morphine while pain persisted in one patient receiving morphine-midazolam. Log-rank test showed no significant difference between the two groups (p=0.55).

CONCLUSION:

Our findings revealed that adding midazolam to morphine did not improve its pain-relief profile.

• Authors: Alireza Majidi, Hossein Dinpanah, Sahar Ashoori, Hassan Motamed, Ali Tabatabaey
• Journal: Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES (Ulus Travma Acil Cerrahi Derg) Vol. 21 Issue 1 Pg. 22-6 (Jan 2015) ISSN: 1306-696X [Print] Turkey
• PMID: 25779708 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Analgesics, Opioid
• Hypnotics and Sedatives
• Morphine
• Midazolam

Topics

• Adolescent
• Adult
• Analgesics, Opioid (administration & dosage, therapeutic use)
• Double-Blind Method
• Drug Therapy, Combination
• Female
• Fractures, Bone (surgery)
• Humans
• Hypnotics and Sedatives (administration & dosage, therapeutic use)
• Infusions, Intravenous
• Male
• Midazolam (administration & dosage, therapeutic use)
• Middle Aged
• Morphine (administration & dosage, therapeutic use)
• Pain Measurement
• Pain, Postoperative (prevention & control)
• Treatment Outcome
• Young Adult