Combined intra-articular glucocorticoid, bupivacaine and morphine reduces pain and convalescence after diagnostic knee arthroscopy.
We studied the effect of intra-articullar saline vs. bupivacaine + morphine or bupivacaine morphine + methylprednisolone after diagnostic knee arthroscopy. In a double-blind randomized study, 60 patients undergoing diagnostic knee arthroscopy without a therapeutic procedure were allocated to groups receiving intra-articular saline, intra-articular bupivacaine 150 mg + morphine 4 mg or the same dose of bupivacaine + morphine + intra-articular methylprednisolone 40 mg at the end of arthroscopy during general anesthesia. All patients were instructed to resume normal activities immediately after the procedure. Pain during movement and walking, leg muscle force and joint effusion, use of crutches and duration of sick leave were assessed. A combination of bupivacaine and morphine reduced pain, duration of immobilization and of convalescence. The addition of methylprednisolone further reduced pain, use of more analgesics, joint swelling and convalescence.
Rasmussen
Sten
S
Department of Orthopedic Surgery, Hvidovre University Hospital, Denmark. sten.rasmussen@dadlnet.dk
Lorentzen
Jan S
JS
Larsen
Allan S
AS
Thomsen
Søren T
ST
Kehlet
Henrik
H
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000627:therapeutic use*; D001182:Arthroscopy / Q000009:adverse effects*; D002045:Bupivacaine / Q000008:administration & dosage* / Q000627:therapeutic use*; D003289:Convalescence; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000627:therapeutic use*; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000187:drug effects / Q000473:pathology*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000627:therapeutic use*; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000627:therapeutic use*; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D010147:Pain Measurement; D013997:Time Factors
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D005938:Glucocorticoids; D009020:Morphine; D008775:Methylprednisolone; D002045:Bupivacaine