Intra-Articular Morphine for Inflammatory Pain

Sex differences in μ‐opioid receptor expression in trigeminal ganglia under a myositis condition in rats

“…Similarly, intra-articular morphine in the temporomandibular joint (TMJ) effectively relieves pain in temporomandibular disorder patients (Ziegler et al, 2010), but render ineffective in patients following TMJ arthroscopy (Bryant et al, 1999). While the discrepant findings seem to undermine the clinical importance of targeting peripheral opioid receptors methodological factors such as study sensitivity, tissue inflammation, or superimposition of general or local anesthetics, which can mask the local opioid effects need to be carefully considered (Stein, 2006; Stein and Küchler, 2012). …”

Modulation of Peripheral Sensory Neurons by the Immune System: Implications for Pain Therapy

“…Although the majority agree on the analgesic efficacy of intra-articular morphine (Gupta et al, 2001;Kalso et al, 2002;Sawynok, 2003), some do not (Rosseland, 2005). Most commonly, negative results have been attributed to lack of study sensitivity (i.e., patients did not have sufficiently high baseline pain scores to detect a significant reduction), lack of tissue inflammation, or the superimposition of general or local anesthetic effects (Kalso et al, 2002;Rosseland, 2005;Stein, 2006). In addition, controversial conclusions from reviews can result from biased selection of studies (Stein, 2006).…”

Analgesic efficacy of intra-articular morphine in experimentally induced radiocarpal synovitis in horses

“…Intra-articular (IA) administration of morphine for pain relief after arthroscopic procedures is used widely as part of multimodal analgesic protocols in humans. A substantial part of the 70 or more controlled trials that have investigated the analgesic effects of IA morphine (Stein 2006) have been included in several major reviews and meta-analyses (Kalso et al 1997(Kalso et al , 2002Gupta et al 2001;Rosseland 2005). Although the majority of studies concluded that IA morphine possesses a significant analgesic effect, lasting up to 24 hours (Kalso et al 1997(Kalso et al , 2002Gupta et al 2001) there is still some debate whether the analgesia is of clinical relevance in humans (Solheim et al 2006;Stein 2006;Rosseland et al 2007).…”