title: Intrathecal hydromorphone added to hyperbaric bupivacaine for postoperative pain relief after knee arthroscopic surgery:  a prospective, randomised, controlled trial.
abstract: OBJECTIVE
  Adding opioid to spinal anaesthetic provides additional analgesia during the postoperative period. The purpose of this study was to determine the dose of intrathecal hydromorphone necessary to achieve postoperative pain relief after arthroscopic knee surgery.
  
  
  METHODS
  In a prospective, double-blinded parallel, placebo-controlled manner, 60 patients who were undergoing unilateral knee arthroscopy randomly received unilateral spinal anaesthesia with 0.5% hyperbaric bupivacaine 6 mg combined with 0.0, 2.5, 5.0 or 10.0 μg per 0.05 ml hydromorphone. Fifteen patients were assigned to receive each dose. The visual analogue pain scores (VAPSs) were measured at 30 min and 2, 4, 6, 12 and 24 h postoperatively, and the side-effects of hydromorphone were recorded.
  
  
  RESULTS
  The postoperative VAPSs at 4, 6 and 12 h for the 5 and 10 μg hydromorphone groups were significantly decreased, compared to the control group. The 2.5 μg hydromorphone group had lower VAPS only at 4 and 6 h postoperatively. Nausea was significantly increased in the 10 μg hydromorphone group (46.6%).
  
  
  CONCLUSIONS
  The analgesic effects of 5 and 10 μg intrathecal hydromorphone provided satisfactory pain relief for 12 h postoperatively and nausea increased significantly in a dose-dependent manner.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan City, Kyeongi Province, Korea.
authors.forename: Yoon-Sook
authors.initials: YS
authors.lastname: Lee
authors.forename: Young-Cheol
authors.initials: YC
authors.lastname: Park
authors.forename: Jae-Hwan
authors.initials: JH
authors.lastname: Kim
authors.forename: Woon-Young
authors.initials: WY
authors.lastname: Kim
authors.forename: Seung-Zjoo
authors.initials: SZ
authors.lastname: Yoon
authors.forename: Man-Gook
authors.initials: MG
authors.lastname: Moon
authors.forename: Too Jae
authors.initials: TJ
authors.lastname: Min
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D000775:Anesthesia, Spinal; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001182:Arthroscopy / Q000009:adverse effects*; D002045:Bupivacaine / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D004091:Hydromorphone / Q000008:administration & dosage* / Q000009:adverse effects; D007278:Injections, Spinal; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D010919:Placebos; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D011446:Prospective Studies; D056910:Republic of Korea; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D010919:Placebos; D004091:Hydromorphone; D002045:Bupivacaine