Comparison of postoperative analgesia after intraarticular injection of two different doses of morphine (5 mg) and Morphine (10 mg) with 0.5% bupivacaine in arthroscopic knee surgery : Randomized, double blinded prospective study

Authors : Geetha Acharya, Sumedha Mehta

DOI : 10.18231/j.ijca.2019.111

Volume : 6

Issue : 4

Year : 2019

Page No : 570-575

Introduction and Aims: Pain relief after knee arthroscopy is preferred for early recovery and mobility.
We aim to compare effectiveness and safety of different doses of morphine 5mg and 10mg combined with
0.5% bupivacaine given intra- articularly after knee arthroscopy for postoperative analgesia.
Materials and Methods: This prospective, double blind study was done in 80 patients of either sex,
undergoing elective diagnostic / therapeutic arthroscopic knee surgery under spinal anesthesia. Patients
were randomly allocated to two groups. 20 ml of 0.5% Bupivacaine with 5 mg, 10 mg morphine as additive
were injected intra-articularly in Group 1 and Group 2 respectively. Postoperative analgesia was assessed
by Visual Analogue Scale at the 1st, 2nd, 4th, 6th, 12th, 18th and 24th after surgery. Time of the first
request of rescue analgesia when VAS>4, total rescue analgesic consumption and any side effects in first
24 hour postoperatively was recorded.
Results: Time of first postoperative rescue analgesic was significantly longer in Group 2 (464.88 25.00
min) compared to Group 1 (442.75 39.79 min). Post-operative VAS score was significantly lower at 6th,
8th, 12th and 24th hour in Group 2. Total dose of analgesic used in 24 hours in Group 2 was significantly
lower than Group 1. Few side effects noted in both groups were comparable.
Conclusion: We conclude that intraarticular dose of 10mg Morphine is better than 5mg Morphine with 20
ml of 0.5% Bupivacaine as it provides better postoperative analgesia with longer duration and minimal side
effects.

Keywords: Arthroscopy, Morphine, Postoperative, Analgesia, Bupivacaine, Intraarticular.


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