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No benefit seen with addition of periarticular morphine injections for bilateral TKA
The addition of morphine to periarticular injections administered in patients who underwent simultaneous bilateral total knee arthroplasties was not effective for pain relief, reduced swelling and improved postoperative range of motion, according to results of a recently published study.
Researchers performed a prospective, single-center, double-blinded, randomized, controlled trial of 53 patients who underwent bilateral TKA to assess the local efficacy of adding morphine to intraoperative periarticular anesthesia. In one knee, patients received the periarticular injection with added morphine. In the other knee, the injection was administered without morphine. The two knees were compared for VAS pain scores at rest and during motion, range of motion, thigh swelling, WOMAC scores and adverse outcomes.
Investigators found the VAS pain score was not significantly different at rest and in motion during any postoperative time point. The two knees were also not significantly different for all other outcomes measures. The WOMAC score at 3 months postoperatively in the knee administered the periarticular injection with morphine and the knee administered the injection without morphine was 18.7 and 19.5, respectively.
Investigators noted vomiting episodes were seen in 19 patients, and 26 patients needed antiemetic drugs. According to researchers, none of the patients developed surgical site infections, peroneal nerve palsy or deep venous thrombosis. – by Monica Jaramillo
Disclosure s : The authors report no relevant financial disclosures.