INTRAARTICULAR MORPHINE FOR POSTOPERATIVE ANALGESIA FOLLOWING KNEE ARTHROSCOPY

Background and Objectives. To determine whether morphine or bupivacain e injected intraarticularly has any beneficial effect on pain relief o r analgesic requirements in the postoperative period following minor a rthroscopic knee procedures. Methods. This was a two-stage, prospectiv e, double-blind, randomized, and controlled study done on young health y patients. A standardized general anesthetic was given to all 149 pat ients and the study was divided into two parts. Part 1: at the end of surgery, one of the following solutions was injected intraarticularly in a random fashion: group M, 1 mg morphine (1 mL) in 19 mL of 0.9% sa line; group P, 20 mL of 0.9% saline (placebo); group B, 20 mL of 0.25% bupivacaine; and group MB, 1 mg of morphine + 19 mL of bupivacaine 0. 25%. Part 2: at the end of surgery, one of the following solutions was injected randomly intraarticularly: group M, 5 mg morphine (5 mL) in 35 mL of 0.9% saline; group P, 40 mL of 0.9% saline (placebo); and in group IM, 5 mg morphine intramuscularly + 40 mL saline intraarticularl y. Postoperative analgesia was assessed after 30, 60, 90, and 120 minu tes using a linear visual analog scale. This was repeated at 8, 24, an d 48 hours after the operation by the patient at home. The number of a nalgesic tablets consumed in the first 48 hours were also counted. Res ults. No difference was seen in the visual analog scale scores between the different groups in either part of the study. The postoperative a nalgesic requirement was similar between the groups. Conclusions. Morp hine 1 mg or 5 mg, or bupivacaine 50 mg do not provide clinically sign ificant postoperative analgesia when given intraarticularly in patient s undergoing minor diagnostic arthroscopic surgery.