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Effects of Intraarticular Morphine on Analgesic Requirements After Anterior Cruciate Ligament Repair
  1. G. P. Joshi, M.D., F.F.A.R.C.S.I.*,
  2. M. Mcswiney, F.F.A.R.C.S.I., F.C.Anaes.,
  3. B. J. Hurson, M.Ch., F.R.C.S.I.§,
  4. S. M. Mccarroll, F.F.A.R.C.S.I.** and
  5. P. O'rourke, F.R.C.S.I.
  1. *Senior Research Associate/Consultant Anesthetist.
  2. **Consultant Anesthetist.
  3. Senior Research Associate.
  4. Orthopedic Registrar.
  5. §Consultant Orthopedic Surgeon.
  6. From the Department of Anesthesia, Cappagh Orthopedic Hospital and Mater Misericordiae Hospital, Dublin, Ireland.
  1. Address correspondence to Dr. Girish Joshi, Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75235-9008.


Background and Objectives. Intraarticular morphine has been shown to provide postoperative pain relief after knee arthroscopy. The analgesia results from local action within the knee joint. This study was conducted to assess the efficacy of intraarticular morphine as a treatment for postoperative pain after anterior cruciate ligament repair.

Methods. A randomized double blind-study was conducted in patients undergoing elective anterior cruciate ligament repair. Patients in the study group ( n = 10) received intraarticularly 5 mg of morphine in a 25 ml dilution. Those in the control group ( n = 10) received 25 ml of saline by the same route. Intravenous morphine with patient-controlled analgesia was used in the postoperative period in both the groups. Visual analog scores were recorded at 1, 2, 4, 8, and 24 hours after the operation. The amount of morphine used over the 24-hour postoperative period was documented.

Results. The total consumption of morphine over the 24-hour period was significantly lower ( p < 0.01) in the study group compared to the control group. The postoperative pain scores were lower in the study group throughout the study period, but this did not reach statistical significance.

Conclusions. Intraarticular morphine reduces analgesic requirements after anterior cruciate ligament repair and is an effective method of providing postoperative analgesia.

  • Postoperative analgesia
  • intraarticular morphine
  • anterior cruciate ligament repair.

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