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British Journal of Anaesthesia, 1994, Vol. 73, No. 3 413-415
© 1994 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

Intra-articular morphine after arthroscopic knee operation

M. F. HEINE, MD, E. D. TILLET, MD, K. TSUEDA, MD, G. E. LOYD, MD, J. A. SCHROEDER, MD, R. L. VOGEL, PHD and A. YLI-HANKALA, PHD

Department of Anesthesiology, University of Louisville School of Medicine Louisville, KY, USA
Department of Orthopedic Surgery, University of Louisville School of Medicine Louisville, KY, USA
Department of Information Technology, University of Louisville School of Medicine Louisville, KY, USA

Reports on pain relief with intra-articular morphine after arthroscopic knee operation are conflicting. To assess the long-term antinociceptive effect of intraarticular morphine, we studied pain at rest, pain on standing and ability to walk for 7 days after intraarticular injection of bupivacaine 100 mg (group 1, n = 11), bupivacaine 100 mg and morphine 1 mg (group 2, n = 10) and bupivacaine 100 mg and morphine 3mg (group 3, n = 10) at the end of operation. Pain and walking were assessed by visual analogue and walking scales, respectively. Pain was treated with morphine i.v. in the recovery room and Tylenol No. 3 after discharge. Assessments were made before operation, and 1, 3, 6 and 12 h after injection and on days 1–7 after operation. There were significant differences between the groups in pain scores (pain at rest, P < 0.05; pain on standing, P < 0.01). The pain scores in group 3 were lower than those in group 1. The differences in pain scores at rest were significant at 12 h and on day 1 after operation and differences in pain scores on standing were significant at 12 h and on days 1 and 2 after operation. The scores in group 2 were intermediate between those in groups 1 and 3. The walking scores in group 3 were significantly better than those in group 1 at 12 h. The amount of analgesics received in groups 2 and 3 was significantly less than that in group 1 until day 3 after operation. Intra-articular morphine 3 mg was effective in providing prolonged pain relief after arthroscopic knee operation.


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