Lin T.-F.YU-CHANG YEHYen Y.-H.YONG-PING WANGLin C.-J.WEI-ZEN SUN2018-09-102018-09-102005http://www.scopus.com/inward/record.url?eid=2-s2.0-19944365226&partnerID=MN8TOARShttp://scholars.lib.ntu.edu.tw/handle/123456789/312984Background. This study was designed to examine the analgesic and dose-related antiemetic efficacy of diphenhydramine-morphine mixture for intravenous patient-controlled analgesia (PCA). Methods. Healthy women, undergoing abdominal total hysterectomy were recruited to this double-blinded randomized placebo-controlled study. Patients were randomly allocated to one of three groups (n=40 each). In group 1, patients received saline at induction and morphine 1 mg ml-1 alone for postoperative PCA. Patients in groups 2 and 3 received diphenhydramine 30 mg i.v. at induction and were given a 1.2:1 or a 4.8:1 ratio, respectively, of diphenhydramine-morphine mixture for postoperative PCA. Results. A total of 112 patients completed the study. The incidence of postoperative nausea (31.6% vs 67.6%, P<0.01) and vomiting (15.8% vs 40.5%, <0.05) was significantly lower in group 3 than in group 1. Furthermore, the incidence of severe nausea was significantly lower in group 3 than in group 1 (2.6% vs 24.3%, P<0.05). The rescue antiemetic requirements were also significantly less in group 3 than in group 1 (5.3% vs 24.3%, P<0.05). However, there was no significant difference between group 2 and group 1 in any of the comparisons. Pain intensity, 24-h morphine consumption and diphenhydramine-related side-effects, such as sedation or dry mouth, did not differ among the three groups. Conclusion. An initial bolus of diphenhydramine 30 mg at anaesthetic induction followed by postoperative PCA with a 4.8:1, but not 1.2:1, diphenhydramine-morphine mixture provides an effective antiemetic efficacy without morphine-sparing effects. ? The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved.Analgesia, patient-controlled; Antiemetic, diphenhydramine; Complications postoperative nausea and vomiting[SDGs]SDG3diphenhydramine; morphine; placebo; prochlorperazine; sodium chloride; abdominal hysterectomy; add on therapy; adult; aged; analgesic activity; antiemetic activity; article; bolus injection; clinical trial; controlled clinical trial; controlled study; disease severity; double blind procedure; drug efficacy; female; human; incidence; major clinical study; patient controlled analgesia; postoperative analgesia; postoperative nausea and vomiting; postoperative pain; priority journal; randomized controlled trial; sedation; somnolence; statistical analysis; xerostomiajournal article10.1093/bja/aei137