Department of Anesthesiology, Hazrate Rasool Akram Hospital, Iran University of Medical Sciences and Health Services, TEHRANIRAN.
Background: This study was conducted to compare the sedative and hemodynamic effects of morphine and remifentanil in traumatized patients requiring intubation and mechanical ventilation in intensive care unit of Rasool Akram Hospital, Iran University of Medical science during the years 2003-4. Material and Methods: This was a randomized controlled clinical trial study in which all traumatized patients requiring mechanical ventilation in ICU were randomly enrolled into two groups. The first group was given a 5 mg bolus dose of morphine and the second group received an infusion of remifentanil starting with 0.05 µgr/kg and the doses were sequentially increased to reach a sedation state of 3-4 according to Ramsey scale. The regimen was continued for 24 hours, during which blood pressure, heart rate, and respiratory rate was monitored. Data were analyzed using SPSS software version 11.5. Results: A total of 60 patients aged 18-80 yrs with mean age of 42.53 ±18.5 yrs, consisting of 37 (61.7%) males and 23 (38.3%) females entered the study. The mean blood pressure was 109.12±1.68 mmHg in the morphine group and 90.01 ±6.66 mmHg in the remifentanil group (p <0.00). The mean heart rate of the aforementioned groups were 101.89 ±2.31 and 95.06±10.15 ( p <0.00) respectively. Conclusion: Remifentanil causes an initial decline in blood pressure but it maintains the pressure in a rather steady state during the period of infusion. This result was quite similar to that of morphine with the additional fact that there was no profound decline of blood pressure with morphine. (Tanaffos 2005; 4(14): 31-36)