JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
QUICK SEARCH:   [advanced]


     

Anesth Analg 1992; 74:822-826
© 1992 International Anesthesia Research Society
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Heard, S. O.
Right arrow Articles by Willock, M. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Heard, S. O.
Right arrow Articles by Willock, M. M.

Analgesic Effect of Intraarticular Bupivacaine or Morphine After Arthroscopic Knee Surgery

A Randomized, Prospective, Double-Blind Study

Stephen O. Heard, MD, W. Thomas Edwards, PhD, MD, Dudley Ferrari, MD, Deborah Hanna, RN, Patricia D. Wong, RN, Astrid Liland, MD, and Marcelle M. Willock, MD

Departments of Anesthesiology and Surgery, University of Massachusetts Medical Center, Worcester, Massachusetts, and University Hospital, Boston University Medical Center, Boston, Massachusetts

The effect of 20 mL of intraarticular bupivacaine (0.25%, with or without 1:200,000 epinephrine), morphine (0.03%, with or without 1:200,000 epinephrine), or normal saline on postoperative analgesia after arthroscopic knee surgery was studied in a randomized, prospective, double-blind trial in ASA I–III outpatients receiving general anesthesia (n = 112) or regional anesthesia (n = 27 [spinal (n = 25) or epidural (n = 2)]). The visual analogue pain scores in the postanesthesia care unit and 3, 6, 12, and 24 h after surgery, time to first analgesic use, and total 24-h analgesic requirements were recorded. In those who received general anesthesia, the visual analogue scores were significantly lower in the bupivacaine group compared with both the morphine- and placebo-treated patients (P < 0.05). The time to first analgesic use was longer in both the bupivacaine and morphine groups when compared with the control group (P < 0.05). No significant differences were detected in total 24 h analgesic requirements among the groups. Patients who had received regional anesthesia had lower visual analogue scores compared with patients who had received general anesthesia irrespective of the intraarticular treatment (P < 0.05). Our results indicate that intraarticular injection of bupivacaine after arthroscopic knee surgery provides prolonged analgesia but that there is no significant prolonged analgesia provided by intraarticular morphine.




This article has been cited by other articles:


Home page
 Am J Sports MedHome page
R. D. Parker, K. Streem, L. Schmitz, M. Group, and P. A. Martineau
Efficacy of Continuous Intra-articular Bupivacaine Infusion for Postoperative Analgesia After Anterior Cruciate Ligament Reconstruction: A Double-Blinded, Placebo-Controlled, Prospective, and Randomized Study
Am. J. Sports Med., April 1, 2007; 35(4): 531 - 536.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
C. A. Busch, B. J. Shore, R. Bhandari, S. Ganapathy, S. J. MacDonald, R. B. Bourne, C. H. Rorabeck, and R. W. McCalden
Efficacy of Periarticular Multimodal Drug Injection in Total Knee Arthroplasty. A Randomized Trial
J. Bone Joint Surg. Am., May 1, 2006; 88(5): 959 - 963.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
M. Kizilkaya, O. S. Yildirim, N. Dogan, H. Kursad, and A. Okur
Analgesic Effects of Intraarticular Sufentanil and Sufentanil Plus Methylprednisolone After Arthroscopic Knee Surgery
Anesth. Analg., April 1, 2004; 98(4): 1062 - 1065.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
G. A. Liguori, G. F. Chimento, L. Borow, and M. Figgie
Possible Bupivacaine Toxicity After Intraarticular Injection for Postarthroscopic Analgesia of the Knee: Implications of the Surgical Procedure
Anesth. Analg., April 1, 2002; 94(4): 1010 - 1013.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
P. N. Convery, K. R. Milligan, P. Quinn, J. Sjovall, and U. Gustafsson
Efficacy and uptake of ropivacaine and bupivacaine after single intra-articular injection in the knee joint
Br. J. Anaesth., October 1, 2001; 87(4): 570 - 576.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
A. Gupta, L. Bodin, B. Holmstrom, and L. Berggren
A Systematic Review of the Peripheral Analgesic Effects of Intraarticular Morphine
Anesth. Analg., September 1, 2001; 93(3): 761 - 770.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
E. C. McCarty, K. P. Spindler, E. Tingstad, Y. Shyr, and M. Higgins
Does Intraarticular Morphine Improve Pain Control with Femoral Nerve Block after Anterior Cruciate Ligament Reconstruction?
Am. J. Sports Med., May 1, 2001; 29(3): 327 - 332.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
J. H. Vranken, K. C. P. Vissers, R. de Jongh, and R. Heylen
Intraarticular Sufentanil Administration Facilitates Recovery After Day-Case Knee Arthroscopy
Anesth. Analg., March 1, 2001; 92(3): 625 - 628.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
S. S. Reuben and J. Sklar
Pain Management in Patients Who Undergo Outpatient Arthroscopic Surgery of the Knee
J. Bone Joint Surg. Am., December 1, 2000; 82(12): 1754 - 1754.
[Full Text]

Home page
 J. Pharmacol. Exp. Ther.Home page
Y. Kolesnikov and G. W. Pasternak
Topical Opioids in Mice: Analgesia and Reversal of Tolerance by a Topical N-Methyl-D-Aspartate Antagonist
J. Pharmacol. Exp. Ther., July 1, 1999; 290(1): 247 - 252.
[Abstract] [Full Text]

Home page
 Am J Sports MedHome page
C. J. Gatt Jr, R. D. Parker, J. E. Tetzlaff, M. Z. Szabo, and A. B. Dickerson
Preemptive Analgesia: Its Role and Efficacy in Anterior Cruciate Ligament Reconstruction
Am. J. Sports Med., July 1, 1998; 26(4): 524 - 529.
[Abstract] [Full Text] [PDF]

Home page
 Arch SurgHome page
C. Y. Ko, J. E. Thompson Jr, A. Alcantara, and D. Hiyama
Preemptive Analgesia in Patients Undergoing Appendectomy
Arch Surg, August 1, 1997; 132(8): 874 - 878.
[Abstract] [PDF]

Home page
 JBJSHome page
N. H. BADNER, R. B. BOURNE, C. H. RORABECK, S. J. MACDONALD, and J. A. DOYLE
Intra-Articular Injection of Bupivacaine in Knee-Replacement Operations. Results of Use for Analgesia and for Preemptive Blockade
J. Bone Joint Surg. Am., May 1, 1996; 78(5): 734 - 8.
[Abstract] [Full Text]

Home page
 NEJMHome page
C. Stein
The Control of Pain in Peripheral Tissue by Opioids
N. Engl. J. Med., June 22, 1995; 332(25): 1685 - 1690.
[Full Text] [PDF]

Home page
 Am J Sports MedHome page
J. W. Jaureguito, J. F. Wilcox, S. J. Cohn, R. A. Thisted, and B. Reider
A Comparison of Intraarticular Morphine and Bupivacaine for Pain Control After Outpatient Knee Arthroscopy: A Prospective, Randomized, Double-Blinded Study
Am. J. Sports Med., June 1, 1995; 23(3): 350 - 353.
[Abstract] [PDF]

Home page
 Am J Sports MedHome page
P. A. Ruwe, I. Klein, and C. L. Shields
The Effect of Intraarticular Injection of Morphine and Bupivacaine on Postarthroscopic Pain Control
Am. J. Sports Med., January 1, 1995; 23(1): 59 - 64.
[Abstract] [PDF]


Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1992 by the International Anesthesia Research Society.