The Effect of Intraoperative Morphine Use on Postoperative Pain in Coronary Artery Bypass Surgery: A Randomized, Controlled Clinical Trial

What this Trial Is About

Researchers are evaluating the effects of intraoperative morphine use on postoperative pain in patients undergoing elective coronary artery bypass grafting (CABG) surgery. This randomized, controlled, single-center trial includes adult patients aged 18 to 80 years classified as ASA III. The study compares the postoperative pain outcomes between patients receiving morphine during surgery and those receiving standard fentanyl infusions. The study is conducted at Istanbul University-Cerrahpaa Cardiology Institute with careful monitoring and standardized anesthesia. Patients are randomly assigned to one of two groups: the Morphine Group receives 5 mg of intravenous morphine before surgery and an additional 5 mg after cardiopulmonary bypass, while the Control Group receives a continuous fentanyl infusion throughout the surgery. Anesthesia is maintained with propofol, fentanyl, and rocuronium using total intravenous anesthesia. Post-surgery, all patients receive intravenous paracetamol and tramadol in the ICU. Pain management and assessment continue postoperatively using morphine if pain scores exceed 4. Throughout the study, participants undergo monitoring including heart rate, blood pressure, oxygen saturation, and mechanical ventilation parameters. Pain intensity is measured at multiple surgical sites at 1, 2, 4, 8, and 24 hours after extubation using the Numerical Rating Scale and Visual Analog Scale. Additional postoperative factors such as nausea, vomiting, ileus, respiratory depression, and duration of mechanical ventilation are recorded. Data on surgery duration, anesthesia, and medication doses are collected. Safety and pain outcomes are closely observed by blinded assessors over the postoperative period.

Effect of Intraoperative Morphine on Postoperative Pain After CABG