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Medline ® Abstract for Reference 103

of 'Prevention and management of side effects in patients receiving opioids for chronic pain'

103
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Effects of nonsteroidal antiinflammatory drugs on patient-controlled analgesia morphine side effects: meta-analysis of randomized controlled trials.
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Marret E, Kurdi O, Zufferey P, Bonnet F
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Anesthesiology. 2005;102(6):1249.
 
Nonsteroidal antiinflammatory drugs (NSAIDs) are commonly combined with intravenous morphine patient-controlled analgesia to relieve postoperative pain. NSAIDs have a documented 30-50% sparing effect on morphine consumption. However, most of the studies have not demonstrated a decrease in morphine adverse effects. A meta-analysis of randomized controlled trials was performed to evaluate the risk of morphine adverse effects in patients treated with NSAIDs. Twenty-two prospective, randomized, double-blind studies including 2,307 patients were selected. NSAIDs decreased significantly postoperative nausea and vomiting by 30%, nausea alone by 12%, vomiting alone by 32% and sedation by 29%. A regression analysis yielded findings indicating that morphine consumption was positively correlated with the incidence of nausea and vomiting. Pruritus, urinary retention, and respiratory depression were not significantly decreased by NSAIDs.
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Department of Anesthesiology and Critical Care, Tenon University Hospital, 4 rue de la Chine, 75970 Paris Cedex 20, France. emmanuel.marret@tnn.ap-hop-paris.fr
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