Comparison of morphine-midazolam versus morphine injection for pain relief in patients with limb fractures - a clinical trial

Ulus Travma Acil Cerrahi Derg. 2015 Jan;21(1):22-6. doi: 10.5505/tjtes.2015.64494.

Abstract

Background: Pain relief, using opiates as a primary choice, is an important part of treating limb fractures. Yet, in order to reduce opiate consumption, other combinations have been introduced. This study aimed to compare pain reduction by a combination of morphine-midazolam with morphine injection in patients with limb fractures.

Methods: A randomized double-blind study of patients with upper or lower extremity fractures was conducted. Patients' response to treatment with either morphine-midazolam solution or morphine at 15, 30, 45, 60, 120, and 180 minutes were assessed. The Kaplan-Meier curves and generalized estimating equations were examined to evaluate the success of treatment.

Results: A total of seventy-two patients aged 18-60 (80.6% male; mean age: 35±17.9 years) were included. At 15, 30, 45, and 60 minutes, successful pain control was seen in 8.83 22.2%, 33.3% and 63.9% of the patients in the morphine group, and 11.1%, 27.7%, 44.4% and 63.8% in the midazolam-morphine group. By the third hour, pain-control was achieved in all patients receiving morphine while pain persisted in one patient receiving morphine-midazolam. Log-rank test showed no significant difference between the two groups (p=0.55).

Conclusion: Our findings revealed that adding midazolam to morphine did not improve its pain-relief profile.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / therapeutic use*
  • Double-Blind Method
  • Drug Therapy, Combination
  • Female
  • Fractures, Bone / surgery*
  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Hypnotics and Sedatives / therapeutic use*
  • Infusions, Intravenous
  • Male
  • Midazolam / administration & dosage
  • Midazolam / therapeutic use*
  • Middle Aged
  • Morphine / administration & dosage
  • Morphine / therapeutic use*
  • Pain Measurement
  • Pain, Postoperative / prevention & control*
  • Treatment Outcome
  • Young Adult

Substances

  • Analgesics, Opioid
  • Hypnotics and Sedatives
  • Morphine
  • Midazolam