Comparative evaluation of intra-articular administration of morphine, bupivacaine and morphine with bupivcaine for post operative analgesia following video knee arthroscopy

ABSTRACT

Post arthroscopy analgesia has been provided with intra-articular bupivacaine, but the duration of analgesia was short. In contrast intra-articular morphine has been shown to produce significant but delayed post-operative analgesia. So, the combination of intra-articular morphine and bupivacaine may be the ideal analgesic after knee arthroscopoy. Our work was done to clarify this suggestion, seventy five patients ASA grade I and II, aged 20-60 years, undergoing elective knee arthroscopy under general anesthesia, were randomized into three groups group I received morphine 2 mg in 20cc saline, group II received 20cc of 0.25% of bupivacaine, group III received morphine 2 mg in 20cc of 0.25% of bupivacaine intra-articularly. The visual analogue score [VAS] were performed at 1, 3, 6, 12, and 24 hours post operatively. Group III had significantly lower VAS compared to the other groups at the end of the study, so morphine and bupivacaine provides superior post operative analgesia for up to 24 hours versus bupivacaine or morphine individually