ABSTRACT

The aim of this study was to investigate postoperative analgesic effectiveness of intraarticular (IA), intramuscular (IM) or intrathecal (IT) administration of morphine in arthroscopic knee surgery.

Seventy-six patients with ASA physical status I-II, aged 18 to 65 years, undergoing arthroscopic knee surgery were included in the study. Morphine (10 mg) was given via IA and IM in groups IA (n:21) and IM (n:16), respectively, at the end of the surgical procedure. IT 0.1 mg morphine was administered together with the local anesthetic in Group IT (n:21). Morphine was not applied to 18 control patients (Group C). Visual analogue scale scores for pain were analyzed. Additional analgesic requirement, side effects of morphine and hemodynamic parameters were compared between the groups.

None of the patients in Group IT needed additional analgesic treatment in the first 24 hours, whereas 14.3 %, 25.0 % and 72.2 % of the patients needed additional analgesic administration in the groups IA, IM and C, respectively (p<0.001). There was no difference in nausea or vomiting between groups (p=0.07). Fifteen patients in Group IT and 3 patients in Group IA experienced itching.

Morphine in three administration routes provides similar analgesic effect and better analgesia in comparison to the control group. Due to the higher incidence of side effects in the IT group, either IA or IM route may be chosen for an adequate postoperative analgesia at the dose used in the present study.

Keywords: Intrathecal, intraarticular, intramuscular, morphine, knee surgery, postoperative pain