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Korean J Anesthesiol > Volume 29(2); 1995 > Article
Korean Journal of Anesthesiology 1995;29(2):266-273.
DOI: https://doi.org/10.4097/kjae.1995.29.2.266   
Comparison of Intra-Articular Bupivacaine and Morphine for Pain Relief after Knee Arthroscopy.
Chang Hwan Kim, Byeoung Soon Park, Jeong Ho Kim, Hoon Soo Kang
Department of Anesthesiology, Dongkang Hospital, Ulsan, Korea.
Abstract
The combination of intra-articular morphine and bupivacaine has been suggested as an ideal analgesic after arthroscopy. We performed a randomized double-blind controlled study in patients undergoing elective knee arthroscopy to investigate the analgesic effect of intra-articular morphine and bupivacaine. Sixty ASA physical status 1~2 patients were randomized into one of three treatment groups. All patients received general anesthesia with N2O, O2 and inhalational agents. The drugs were given by intra-articular injection by the surgeon before tourniquet release at the end of the operation. According to the mode of the drugs administered, the patients were divided into three groups; 1) Groupl (n=20) received 0.25% bupivacaine 2) Group2 (n=20) received morphine 1 mg in saline 3) Group3 (n=20) received morphine 1 mg in 0.25% bupivacaine. The injected volume was 25 ml, and all solutions contained 1:250,000 epinephrine. Additional postoperative analgesia was provided with intramuscular diclofenac sodium. The visual analogue pain scores in the recovery room(0.5 h) and 2, 4, 8, 12 and 24 h after surgery, time to first analgesic use, and total 24 h additional analgesic requirements were recorded. The results were as follows; 1) Visual analogue pain scores were lower in group 1 and 3 at 1~8 h. 2) Visual analogue pain scores were lower in group 2 and 3 at 24 h. 3) Additional analgesic requirements were lower for the first 12 h in group 1 and 3, but no difference was seen between groups over the 24 h study period. We conclude that, after elective knee arthroscopy, intra-articular morphine 1 mg in 0.25% bupivacaine 25 ml, with 1: 250,000 epinephine, may provide superior postoperative analgesia up to 24 h than bupivacaine or morphine alone.
Key Words: Knee arthroscopy; Morphine and bupivacaine; Analgesic effect


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