Low-dose intra-articular morphine analgesia in day case knee arthroscopy: a randomized double-blinded prospective study.
The aim of this study was to demonstrate the effect of intra-articular morphine following knee arthroscopy performed in infiltration analgesia. Fifty-two healthy patients were randomized to receive either 1 mg of morphine or placebo. The pain was assessed 2, 4, 8 and 24 h after the procedure by (1) a VAS scale and (2) the amount of acetaminophen consumed. Demographic data in the 2 groups were similar. The pain scores at 8 and 24 h and the acetaminophen consumption after 8 h were lower in the morphine group (P < 0.05). Our results support the hypothesis of peripherally distributed opioid receptors. Stratifying data in therapeutic versus diagnostic arthroscopy indicated additional effect of morphine in patients undergoing therapy (P < 0.1), an aspect supporting the hypothesis of peripherally administered morphine as a potential suppressor of the substance P-mediated cytokine cascade and the peripheral leukocyte activity. Intra-articular morphine (1 mg) after knee arthroscopy offers efficient analgesia lasting more than 24 h. The method is devoid of side effects and deserves wider recognition.
Dalsgaard
Joergen
J
Departments of Anaesthesia, Aarhus Amtssygehus, Aarhus University Hospital, DK-8000 Aarhus CDenmark Departments of Orthopaedic Surgery, Aarhus Amtssygehus, Aarhus University Hospital, DK-8000 Aarhus CDenmark.
Felsby
Sven
S
Juelsgaard
Palle
P
Froekjaer
Johnny
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D007273:Injections, Intramuscular; D007717:Knee / Q000601:surgery*; D008012:Lidocaine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000523:psychology; D011446:Prospective Studies
D009020:Morphine; D008012:Lidocaine