Side effects of morphine patient-controlled analgesia and meperidine patient-controlled analgesia: a follow-up of 500 patients.

Many physicians, Certified Registered Nurse Anesthetists (CRNAs), and registered nurses have the clinical impression that either morphine sulfate or meperidine hydrochloride is a better drug to control postoperative pain. In this study, we evaluated pain relief and side effects for these two drugs to assess their potential differences. CRNAs conducted a structured interview of 500 female patients 24 hours after major gynecologic, urologic, or breast surgery. Patients' responses on 4-point scales of none, mild, moderate, and severe were collected for pain intensity, degree of nausea, severity of vomiting and itchiness, and degree of sedation experienced since the operation. There were 91 patients who received morphine patient-controlled analgesia (PCA) and 409 patients administered meperidine PCA. No statistically significant differences for pain intensity, degree of nausea, severity and incidence of vomiting, or degree of sedation were found. However, a significant difference was found in the incidence rates of mild itchiness, which occurred more frequently in the morphine PCA group (P less than .001). Patients vomited more often after vaginal hysterectomy than patients having laparotomy, major oncology, or tuboplasty surgeries (P less than .05), and vaginal repair patients reported more vomiting than patients having major oncology or tuboplasty surgeries. Clinical impressions that either morphine or meperidine should be the preferred treatment for patients following gynecologic operations was not found by a 24-hour review of 500 patients for pain relief and side effects. Although mild itchiness occurred more frequently in the morphine PCA group, treatment was rarely necessary.