Pain relief after arthroscopic knee surgery--intraarticular sufentanil vs morphine

Prevention of postoperative pain by injecting opioid into the knee joint is believed to support the hypothesis of peripheral opioid receptor activation in inflammation. Main outcomes were reduction of pain intensity and need for supplementary analgesics. The aim of the present study was to evaluate the analgesic effects of intraarticular sufentanil in comparison with morphine, following arthroscopic procedures of knee joint.

In this prospective, double-blind study, 45 patients were randomized in three equal number groups to receive either sufentanil 5 ug (group S), morphine 3 mg (group M) or normal saline 20 cc as placebo, (group P) intra-articularly at the end of arthroscopic knee surgery, under general anesthesia. Pain levels at rest and at intervals of 1,2,4,8,12,14 hours and during movement of knee at discharge time, were measured by a Visual Analog Scale (VAS) and Numeric Rating Scale (NRS) postoperatively and the day after surgery.

Significant difference between the groups (p < 0.001) were found. Pain scores were statistically lower in the sufentanil (S) and morphine (M) groups in comparison with the normal saline placebo (P) group. Inta-articular sufentanil was however more effective than morphine.

The Intra-articular injection of morphine and sufentanil, reduce both the post arthroscopic knee procedures pain, and the need for supplementary analgesics. However, sufentanil, 5 microg is more effective than morphine.