Intra-articular morphine and postoperative analgesia after knee arthroscopy

No evidence for analgesic effect of intra-articular morphine after knee arthroscopy: A qualitative systematic review

“…1 Such imbalance may be of importance in several RCTs. 35,36,38,39,44,45,[48][49][50][51][52][53][54][55][56][57][58][59][60][61] All these trials, placebo controlled or not, had a group size below 20, which gives an OPVS item number 2 score of 0/3.…”

Comparisons of analgesic effects of different doses of morphine and morphine plus methylprednisolone after knee surgery

“…In addition, supplementary analgesic requirement after arthroscopy with spinal anaesthesia was lower in the 5 mg morphine groups than the 1 mg morphine groups [1]. Drosos and colleagues found that neither the low (5 mg) nor the high dose (15 mg) of morphine solution administered intra-articularly, provided significantly better analgesia and achieved lower pain scores compared to the control group [23]. Meta-analysis performed by Gupta and colleagues [16] showed that 1 mg morphine had no benefit in two studies and less pain in four studies as compared to placebo.…”

Local Anesthetic Agents in Arthroscopy

“…While pain intensity or pain scale score is a frequent measure in these studies, the actual need for additional analgesia is a limiting factor with regard the ability to perform a procedure as a day case or not and may reflect a more practical end-point for further research. Despite a small number of studies suggesting that morphine provides adequate analgesic control following knee a recent review of these studies has suggested that of the higher quality studies, most had a negative finding not in favor of its use as an intra-articular analgesic agent (Rosseland, 2005, Drosos et al, 2002. The key point of this review was that post-operative pain intensity was no less in the morphine treated groups than the placebo treated groups in the well-designed studies.…”

“…(Drosos et al, 2002) RCT 30 No significant difference seen in VAS pain scores between patients receiving intra-articular saline, 5mg morphine or 15mg morphine following diagnostic arthroscopy or arthroscopic meniscectomy. (Elhakim et al, 1999) RCT 60…”