• W Scott Jellish, John P Leonetti, Kristina Sawicki, Douglas Anderson, and Thomas C Origitano.
• Department of Anesthesiology, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153, USA. wjellis@lumc.edu
• Otolaryngol Head Neck Surg. 2006 Aug 1;135(2):175-81.

ObjectivePatients who underwent skull base procedures have been noted to experience appreciable pain. This study examines pain after surgery and the effectiveness of patient controlled analgesia (PCA) with combination morphine ondansetron for analgesia and control of emesis.Study Design And SettingA total of 120 skull base surgery patients were randomized to receive placebo, morphine, or morphine ondansetron. Demographic and intraoperative variables were recorded along with pain, nausea, vomiting, and rescue analgesics. Total PCA use, hospital stay, satisfaction, and cost were also compared.ResultsDemographically the groups were similar. Pain was elevated with placebo PCA, and this group averaged twice as many analgesic rescues. Total usage time was lower with placebo PCA. Morphine ondansetron PCA had the lowest pain score with highest satisfaction. Nausea and vomiting was similar but female patients had more vomiting regardless of PCA group.Conclusions And SignificanceThe use of morphine PCA reduced pain and did not appreciably increase nausea or vomiting. The addition of ondansetron produced no real benefit and its PCA use cannot be justified.Ebm RatingA-1b.

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