فهرست نشریات علمی دسترسی آزاد ایران

Background and Objectives: Effective postoperative pain management is crucial, particularly in spine surgeries, which often result in significant discomfort. Adequate pain control facilitates early ambulation and reduces hospitalization duration. Chronic pain patients undergoing lumbar fusion surgery present additional challenges due to altered pain perception and prolonged opioid use. This study compares the efficacy of ketorolac and ketamine, in combination with morphine, for postoperative analgesia.   Methods: This double-blind randomized clinical trial included lumbar fusion surgery candidates at Imam Khomeini Hospital, Sari. Patients were randomly assigned to three groups receiving ketorolac and morphine (Group A), ketamine and morphine (Group B), or morphine alone (Group C) via PCA pump. Pain intensity (NRS score) at rest and first movement, PCA bolus usage, hospitalization duration, demographic variables, nausea, vomiting, and surgery duration were recorded at multiple time points postoperatively.   Results: A total of 120 patients (mean age: 52.5 years, 55% male) were analyzed. No significant differences were observed in hospitalization duration, gas passage time, or demographic variables. However, pain intensity at movement and multiple time points postoperatively, as well as PCA bolus usage, were significantly lower in Groups A and B compared to Group C. Group B had a lower incidence of nausea and vomiting in the first 2 hours postoperatively.   Conclusion: Ketorolac or ketamine combined with morphine provides superior analgesia compared to morphine alone, with ketorolac demonstrating the most effective pain relief without severe complications.