PMID: 9168214May 1, 1997Paper

Pain relief after knee arthroscopy: intra-articular morphine, intra-articular bupivacaine, or subcutaneous morphine?

Regional Anesthesia
M S CepedaD B Carr

Abstract

This investigation was undertaken to compare analgesic effects, side effects, and requirements for supplemental analgesic therapy after knee arthroscopy in patients given intra-articular (IA) or subcutaneous (SC) morphine, intra-articular bupivacaine, or placebo. In a randomized, double-blind controlled trial, 112 patients, 14-65 years old each received two solutions, one SC and the other IA. Group IAM (n = 30) received 10 mg IA morphine in 20 mL normal saline plus 1 mL of SC normal saline Group IAB (n = 27) received 20 mL IA bupivacaine 0.5% with IA epinephrine plus 1 mL SC normal saline Group SCM (n = 26) received 20 mL IA normal saline plus 10 mg SC morphine in 1 mL. Group P (n = 29) received 20 mL IA normal saline plus 1 mL SC normal saline. Pain was evaluated on arrival in the postanesthesia care unit (PACU), and 30, 45, 60, 90, and 120 minutes afterwards. If pain exceeded 4/10 on a visual analog pain scale in the PACU, 30 mg intravenous ketorolac was given, and if pain persisted, 0.4 mg hydromorphone was added every 7 minutes. After PACU discharge, patients whose pain exceeded 4/10 received oral ketorolac 10 mg every 6 hours; oral acetaminophen plus codeine was added every 4 hours if pain still exceeded 4/10. Analgesic re...Continue Reading

Citations

Sep 9, 2005·Acta Anaesthesiologica Scandinavica·B TuncerM Arslan
Sep 13, 2013·Orthopedics·Hussein ElkousyG William Woods
Jun 23, 2005·International Anesthesiology Clinics·Michael L Kentor, Brian A Williams
Aug 29, 2001·Anesthesia and Analgesia·A GuptaL Berggren
Apr 14, 2010·Anaesthesia·S L Kopp, T T Horlocker
Feb 20, 2010·Journal of Refractive Surgery·Ella G Faktorovich, Allan I Basbaum
Jun 12, 2013·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Jie WeiTu-bao Yang
Jun 1, 2005·Palliative Medicine·Caroline Fonzo-ChristePascal Bonnabry

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