Improved postoperative analgesia with morphine added to axillary block solution.
OBJECTIVE
To determine whether the addition of morphine to the axillary block local anesthetic solution provides improved or prolonged postoperative analgesia.


METHODS
Prospective, randomized, double-blind clinical trial with 24-hour follow-up.


METHODS
Ambulatory unit of a large academic referral center.


METHODS
Consecutive healthy volunteers scheduled for elective upper extremity surgery.


METHODS
Patients in the treatment group (AX) were given intravenous (IV) saline and had morphine 0.1 mg/kg added to their axillary block solution. Control subjects (CT) received morphine 0.1 mg/kg IV and had saline added to their axillary block solution. All axillary blocks were performed using 0.55 ml/kg of 1.5% lidocaine with epinephrine 1:200,000.


RESULTS
During the first 24 hours after surgery, visual analog scale (VAS) scores, supplementary analgesic (oxycodone 5 mg with acetaminophen 500 mg) use, and complications were recorded. Both groups had similar VAS scores throughout the study. In the 24-hour postoperative study period, AX patients required approximately half as many doses (median, 2 doses; range, 0 to 7 doses of supplemental analgesic as CT patients (median, 4 doses; range, 0 to 12 doses). There were no major complications in either group.


CONCLUSIONS
The addition of morphine 0.1 mg/kg to the local anesthetic axillary block solution provided improved postoperative analgesia without an increased frequency of side effects or major complications.
Bourke
D L
DL
Department of Anesthesiology, Johns Hopkins Hospital, Baltimore, MD.
Furman
W R
WR
D000082:Acetaminophen / Q000008:administration & dosage / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000698:Analgesia / Q000379:methods*; D001365:Axilla / Q000294:innervation; D001917:Brachial Plexus; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D009407:Nerve Block / Q000379:methods*; D010098:Oxycodone / Q000008:administration & dosage / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D013997:Time Factors
D000082:Acetaminophen; D009020:Morphine; D010098:Oxycodone