Intra-articular bupivacaine plus opioid for chronic joint pain

ABSTRACT

Traditionally opioids are considered to exert their analgesic effects within the central nervous system. There are receptors in joints also, which are sensitive to minimal doses of opioids. We have injected combined of local anaesthetic and minimal doses of Pethedine/Nubain [Nalbuphine] to see result in chronic osteoartritic knee pain and other small joints pain. The results were compared with Transcutaneous Electrical Nerve Stimulation [TENS], Non Steroidal Anti-inflammatory Drugs [NSADIAs] and Intra-Articular Steroids. We have observed that twice-a-week injection of 10 mg Pethedine or 5mg Nubain plus 10 ml of 0.25% Bupivacaine in a 70kg patient had much longer analgesic effect