INTRAARTICULAR MORPHINE FOR POST OPERATIVE KNEE ARTHROSCOPY ANALGESIA

• Main Authors: Deepak Prakash Mahara, A P Lamichhane
• Format: Article
• Language: English
• Published: Nepal Medical Association 2004-06-01
• Series: Journal of Nepal Medical Association
• Online Access: http://jnma.com.np/jnma/index.php/jnma/article/view/561

Key Words: Knee arthroscopy, Morphine, Opioid receptors, Post-operative pain. The Arthroscopy has dramatically changed the orthopedic surgeon's approach to the diagnosis and treatment of variety of joint ailments. A degree of clinical accuracy, combined with low morbidity has encouraged the use of arthroscopy to assist in diagnosis to determine prognosis and often to provide treatment. Recent work has described peripheral opioid receptors in skin and synovium. The later may respond to the use of intra-articular morphine for analgesia following knee arthroscopy. Two hundred and twenty five patients who had undergone different arthroscopic procedures for the last 3 and half years were prospectively evaluated. Of the total arthroscopic procedures evaluated, meniscal pathology was found in 154 patients, synovial pathology in 14 patients, Anterior CruciateLigament (ACL) and Posterior Cruciate Ligament (PCL) insufficiency in 18 patients, chondral lesions in 25 patients, tight lateral structures in 6 patients and loose bodies in 8 patients. All the patients were operated on outpatient basis. Routine intra-articular morphine (2 mg.) was used for postoperative pain relief. Drain was not put following the procedures. All the patients were seen on the 5th postoperative day. Most patients were satisfied with the pain relief modality and needed analgesics in few patients. Postoperative low dose intra-articular morphine injection has been found to be good alternative to other pain management modalities.