title: Comparison of the analgesic effect of intra-articular and extra-articular injection of morphine and ketamine compound in arthrotomy lower limb surgery under spinal anesthesia.
abstract: OBJECTIVE
  One of the critical components in the postoperative care is pain. Given that little research has been done regarding the analgesic effects of intra-articular injection of ketamine, this study was aimed to compare the analgesic effect of intra-articular and extra-articular injection of morphine and ketamine compound in arthrotomy surgery under spinal anesthesia.
  
  
  METHODS
  A total of 50 patients were candidate for arthrotomy surgery, aged 18-60 years were divided randomly into two groups. At the end of surgery, the first group was treated with combination of intra-articular morphine and ketamine compound and the second group was treated with combination of extra-articular morphine and ketamine compound. The amount of postoperative pain was recorded in the hours of 2,4,6,12,24 respectively. Also 24 hours consumption of rescue analgesic was recorded.
  
  
  RESULTS
  The pain severity (VAS) in the hours of 2, 4, 6, 12 and 24 after surgery in the intra-articular injection group was significantly lower than the extra-articular injection group (P<0.05). Postoperative morphine consumption in intra-articular injection group (3.2±3.78) was significantly less than the extra-articular injection group (6.36±5.22) (p = 0.018).
  
  
  CONCLUSIONS
  Postoperative pain severity of intra-articular injection of ketamine and morphine in knee surgery is less than extra-articular injection.
authors.affiliation: Reza Akhondzade, Assistant Professor, Department of Anesthesiology, Ahvaz Jundishapur University of Medical Science, Pain Research Center, Ahvaz, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Akhondzade
authors.affiliation: Mohammad Reza Pipelzade, Associate Professor, Department of Anesthesiology, Ahvaz Jundishapur University of Medical Science, Pain Research Center, Ahvaz, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Pipelzade
authors.affiliation: Mohammad Reza Gousheh, Assistant Professor, Department of Anesthesiology, Ahvaz Jundishapur University of Medical Science, Pain Research Center, Ahvaz, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Gousheh
authors.affiliation: Naser Sarrafan, Assistant Professor, Department of Orthopedics, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran.
authors.forename: Naser
authors.initials: N
authors.lastname: Sarrafan
authors.affiliation: Kamran Mahmoodi, Resident of Anesthesiology, Department of Anesthesiology, Ahvaz Jundishapur University of Medical Science, Pain Research Center, Ahvaz, Iran.
authors.forename: Kamran
authors.initials: K
authors.lastname: Mahmoodi
keywords: Extraarticular; Intraarticular; Ketamine; Morphine; Post-operative pain