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Intra-articular morphine after arthroscopic knee operation

M F Heine1, E D Tillet, K Tsueda

  • 1Department of Anesthesiology, University of Louisville School of Medicine, KY.

British Journal of Anaesthesia
|September 1, 1994
PubMed
Summary

Intra-articular morphine provided significant long-term pain relief after knee arthroscopy. Higher morphine doses (3 mg) reduced pain and improved walking ability more than lower doses or bupivacaine alone.

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Area of Science:

  • Orthopedic Surgery
  • Pain Management
  • Pharmacology

Background:

  • Conflicting reports exist regarding the efficacy of intra-articular morphine for post-arthroscopic knee pain relief.
  • Assessing the long-term antinociceptive effects is crucial for optimizing pain management strategies.

Purpose of the Study:

  • To evaluate the long-term pain relief and functional outcomes following intra-articular morphine administration after knee arthroscopy.
  • To compare the effects of different doses of intra-articular morphine (1 mg and 3 mg) combined with bupivacaine.

Main Methods:

  • A randomized study involving three groups receiving intra-articular bupivacaine with either no morphine (Group 1), 1 mg morphine (Group 2), or 3 mg morphine (Group 3) post-arthroscopic knee surgery.
  • Pain at rest and on standing, along with walking ability, were assessed using visual analogue and walking scales for 7 days.

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  • Postoperative pain management included intravenous morphine and oral Tylenol No. 3.

    • Main Results:

    • Significant differences in pain scores were observed between groups (pain at rest, P < 0.05; pain on standing, P < 0.01).
    • Group 3 (3 mg morphine) demonstrated lower pain scores and better walking ability compared to Group 1 (bupivacaine only), particularly at 12 hours post-injection.
    • Patients in Groups 2 and 3 required significantly less additional analgesia until day 3 post-operation.

    Conclusions:

    • Intra-articular morphine, particularly at a 3 mg dose, offers significant long-term pain relief and functional improvement after knee arthroscopy.
    • The findings suggest that intra-articular morphine is an effective adjunct for managing post-arthroscopic knee pain, reducing the need for systemic analgesics.