Analgesic efficacy of intra-articular morphine after arthroscopic knee surgery in sport injury patients

Abstract

Abstract:Background:Anterior Cruciate Ligament (ACL) tearing is a common injury among football players. The present study aims to determine the best single-dose of intra-articular morphine for pain relief after arthroscopic knee surgery that, in addition to adequate and long-term analgesia, leads to fewer systemic side effects. Methods:This clinical trial was conducted on 40 ASA-I athletes. After surgery, all participants received an injection of 20cc of 0.5% intra-articular bupivacaine. In addition, the first control group received a saline injection and 5, 10 and 15 mg of morphine were respectively injected into the joints of the second, third and fourth groups by use of Arthroscopic equipment before the Arthroscopic removal. The amount of pain based on VAS at 1, 2, 4, 6 and 24 hours after surgery, duration of analgesia and the consumption of narcotic drugs were recorded. Results:The VAS scores in the fourth, sixth and twenty-fourth hours after surgery showed a significant difference between the study groups. The average time to the first analgesic request from the bupivacaine plus 15 mg morphine group was significantly longer than other groups and total analgesic requests were significantly lower than other groups. No drowsiness complications were observed in any of the groups in the first 24 hours after injection. Conclusions:Application of 15 mg intra-articular morphine after Arthroscopic knee surgery increases the analgesia level as well as its duration (IRCT138902172946N3).

Analgesic efficacy of three different dosages of intra-articular morphine in arthroscopic knee surgeries: Randomised double-blind trial

“…In a study by Yari et al ., 40 patients undergoing anterior cruciate ligament repair were recruited and divided into four groups. [ 11 ] All the patients received 20 cc of 0.5% IA bupivacaine with either NS, 5 mg, 10 mg or 15 mg morphine. The authors observed that 15 mg IA morphine with 20 cc of 0.5% bupivacaine increased the analgesia level as well as its duration.…”

“…Variable doses of IA morphine, ranging from 1 to 10 mg, have been used in various published clinical trials. [ 7 8 9 10 11 12 ]…”

<p>Analgesic Effect of Morphine Added to Bupivacaine in Serratus Anterior Plane Block Following Modified Radical Mastectomy. Only a Local Effect? Randomized Clinical Trial</p>

“…16 Third, several trials found the effectiveness of peripheral opioid injections for local analgesia, such as intra-articular morphine after knee surgery. 17,18 Local opioid analgesic actions are pronounced in inflamed tissues. This may be attributed to the increased number of exposed opioid receptors and/or increased coupling with G-proteins (the degradation of perineural barriers and passage of agonists results in exposure of opioid receptors).…”

Bloqueo regional intraarticular con anestésicos locales en cirugía artroscópica de rodilla

“…Desde que se realiza la artroscopía de rodilla con anestesia local (3) , el resto de las técnicas anestésicas se han utilizado menos, pues el control del dolor intra y postoperatorio son suficientes y las complicaciones escasas (28) .…”

“…Yari y colegas (28) determinaron la mejor dosis única de morfina intraarticular para aliviar el dolor postcirugía artroscópica de rodilla y determinar la mejor analgesia a largo plazo, con menos efectos secundarios sistémicos. Para ello, administraron en 40 atletas ASA-I (después del procedimiento quirúrgico) una inyección de 20 mL de 0.5% intraarticular de bupivacaína con 5, 10 y 15 mg de morfina.…”