Postarthroscopic meniscus repair analgesia with intraarticular ketorolac or morphine.
Both ketorolac, a nonsteroidal antiinflammatory drug, and morphine, an opioid agonist, provide enhanced patient analgesia after arthroscopic knee surgery when administered via the intraarticular route. This study was designed to determine whether ketorolac or morphine results in better patient analgesia and whether their combination would provide superior analgesia to either drug alone. Patients undergoing arthroscopic knee meniscus repair under local anesthesia with sedation were evaluated. Each of the study groups evaluated received ketorolac (either via the parenteral or intraarticular route) and morphine (via either the parenteral or intraarticular route). This study revealed a significant benefit from the individual intraarticular administration of both morphine and ketorolac. The combination of these drugs did not result in decreased postoperative pain or need for postoperative analgesics, and it did not result in an increased analgesic duration. We conclude that the use of either intraarticular ketorolac or intraarticular morphine improves the comfort in patients undergoing arthroscopic meniscus repair and that their combination offers no advantage over either drug alone.
Reuben
S S
SS
Department of Anesthesiology, Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts 01199, USA.
Connelly
N R
NR
D000328:Adult; D000698:Analgesia; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000772:Anesthesia, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001182:Arthroscopy; D016292:Procedural Sedation; D004311:Double-Blind Method; D004338:Drug Combinations; D017558:Elective Surgical Procedures; D004724:Endoscopy; D006801:Humans; D007270:Injections, Intra-Articular; D007275:Injections, Intravenous; D020910:Ketorolac; D008592:Menisci, Tibial / Q000601:surgery*; D009020:Morphine / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000517:prevention & control; D014046:Tolmetin / Q000008:administration & dosage / Q000031:analogs & derivatives*
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004338:Drug Combinations; D009020:Morphine; D014046:Tolmetin; D020910:Ketorolac