Preoperative multimodal administration of morphine in arthroscopic surgery

Introduction The aim of the study was to demonstrate the possible effects of preoperative intraarticular, intravenous, or intrathecal administration of morphine on postoperative pain management. Materials and methods Sixty patients undergoing arthroscopic menisectomy were included. Spinal anesthesia was performed in the lateral decubitus position with 3 ml of 0.5% hyperbaric bupivacaine, and the patients were randomized into 4 groups. The IVM (intravenous, iv, morphine) group received 3 mg of iv morphine after completion of spinal anesthesia, the ITM (intrathecal morphine) group received 0.3 mg of morphine together with bupivacaine during spinal anesthesia, the IAM (intra-articular morphine) group received 3 mg intraarticular morphine diluted in 10 ml of saline after spinal anesthesia had been induced but 15 min before surgery, while the C (control) group did not receive any drugs in addition to spinal anesthesia. The sensory block level was determined 15 min after spinal anesthesia. Pain at rest (by visual analogue scale, VAS) and pain at 30 degrees of flexion (by verbal rating scale, VRS) were evaluated during each of the first 2 h of the postoperative period and once every 4 h thereafter until 24 h. In each group; the number of patients in need of analgesics, the timing of the first analgesic intake (duration of analgesia), and the cumulative dose of analgesics were recorded. Results The mean duration of analgesia in the IAM group was significantly longer and the mean analgesic intake was significantly lower when compared with the other groups) < 0.05). The mean VAS value of the ITM group at the 4th postoperative hour was significantly lower than that of the other groups. Mean VAS values at 8 and 12 h and mean VRS values at 4 and 8 It were significantly lower in the ITM and IAM groups (p < 0.05). The ITM group had the highest rates of nausea, vomiting, pruritus, and headache (p < 0.05). Conclusion It was concluded that the preoperative administration of morphine, either intrathecally or intra-articularly, provides postoperative pain relief. Of these two, the intra-articular route seems to be superior in terms of fewer side-effects (nausea, vomiting, and pruritus), longer duration of analgesia, and reduction of total need for analgesics.

Yazar Altunkaya, H
Ozer, Y
Demirel, CB
Ozkocak, I
Keser, S
Bayar, A
Yayın Türü Article
Tek Biçim Adres https://hdl.handle.net/20.500.12628/3136
Tek Biçim Adres 10.1007/s00402-004-0788-9
Konu Başlıkları arthroscopy
intra-articular morphine
intrathecal morphine
postoperative pain
Koleksiyonlar Araştırma Çıktıları | WoS | Scopus | TR-Dizin | PubMed | SOBİAD
PubMed İndeksli Yayınlar Koleksiyonu
WoS İndeksli Yayınlar Koleksiyonu
Dergi Adı ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
Dergi Cilt Bilgisi 125
Dergi Sayısı 9
Sayfalar 609 - 613
Yayın Yılı 2005
Eser Adı
[dc.title]
Preoperative multimodal administration of morphine in arthroscopic surgery
Yazar
[dc.contributor.author]
Altunkaya, H
Yazar
[dc.contributor.author]
Ozer, Y
Yazar
[dc.contributor.author]
Demirel, CB
Yazar
[dc.contributor.author]
Ozkocak, I
Yazar
[dc.contributor.author]
Keser, S
Yazar
[dc.contributor.author]
Bayar, A
Yayın Yılı
[dc.date.issued]
2005
Yayıncı
[dc.publisher]
SPRINGER
Yayın Türü
[dc.type]
article
Özet
[dc.description.abstract]
Introduction The aim of the study was to demonstrate the possible effects of preoperative intraarticular, intravenous, or intrathecal administration of morphine on postoperative pain management. Materials and methods Sixty patients undergoing arthroscopic menisectomy were included. Spinal anesthesia was performed in the lateral decubitus position with 3 ml of 0.5% hyperbaric bupivacaine, and the patients were randomized into 4 groups. The IVM (intravenous, iv, morphine) group received 3 mg of iv morphine after completion of spinal anesthesia, the ITM (intrathecal morphine) group received 0.3 mg of morphine together with bupivacaine during spinal anesthesia, the IAM (intra-articular morphine) group received 3 mg intraarticular morphine diluted in 10 ml of saline after spinal anesthesia had been induced but 15 min before surgery, while the C (control) group did not receive any drugs in addition to spinal anesthesia. The sensory block level was determined 15 min after spinal anesthesia. Pain at rest (by visual analogue scale, VAS) and pain at 30 degrees of flexion (by verbal rating scale, VRS) were evaluated during each of the first 2 h of the postoperative period and once every 4 h thereafter until 24 h. In each group; the number of patients in need of analgesics, the timing of the first analgesic intake (duration of analgesia), and the cumulative dose of analgesics were recorded. Results The mean duration of analgesia in the IAM group was significantly longer and the mean analgesic intake was significantly lower when compared with the other groups) < 0.05). The mean VAS value of the ITM group at the 4th postoperative hour was significantly lower than that of the other groups. Mean VAS values at 8 and 12 h and mean VRS values at 4 and 8 It were significantly lower in the ITM and IAM groups (p < 0.05). The ITM group had the highest rates of nausea, vomiting, pruritus, and headache (p < 0.05). Conclusion It was concluded that the preoperative administration of morphine, either intrathecally or intra-articularly, provides postoperative pain relief. Of these two, the intra-articular route seems to be superior in terms of fewer side-effects (nausea, vomiting, and pruritus), longer duration of analgesia, and reduction of total need for analgesics.
Açıklama
[dc.description]
WOS: 000233776500005
Açıklama
[dc.description]
PubMed: 15645268
Kayıt Giriş Tarihi
[dc.date.accessioned]
2019-12-23
Açık Erişim Tarihi
[dc.date.available]
2019-12-23
Yayın Dili
[dc.language.iso]
eng
Konu Başlıkları
[dc.subject]
arthroscopy
Konu Başlıkları
[dc.subject]
intra-articular morphine
Konu Başlıkları
[dc.subject]
intrathecal morphine
Konu Başlıkları
[dc.subject]
postoperative pain
Haklar
[dc.rights]
info:eu-repo/semantics/closedAccess
ISSN
[dc.identifier.issn]
0936-8051
ISSN
[dc.identifier.issn]
1434-3916
İlk Sayfa Sayısı
[dc.identifier.startpage]
609
Son Sayfa Sayısı
[dc.identifier.endpage]
613
Dergi Adı
[dc.relation.journal]
ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
Dergi Sayısı
[dc.identifier.issue]
9
Dergi Cilt Bilgisi
[dc.identifier.volume]
125
Tek Biçim Adres
[dc.identifier.uri]
https://dx.doi.org/10.1007/s00402-004-0788-9
Tek Biçim Adres
[dc.identifier.uri]
https://hdl.handle.net/20.500.12628/3136
Görüntülenme Sayısı ( Şehir )
Görüntülenme Sayısı ( Ülke )
Görüntülenme Sayısı ( Zaman Dağılımı )
Görüntülenme
13
09.12.2022 tarihinden bu yana
İndirme
1
09.12.2022 tarihinden bu yana
Son Erişim Tarihi
08 Şubat 2024 17:18
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Tıklayınız
anesthesia morphine spinal postoperative significantly analgesics groups morphine) received patients intraarticular administration duration during analgesia longer values preoperative bupivacaine vomiting analgesic intake recorded compared number groups) timing (nausea pruritus) (duration analgesia) cumulative reduction Results provides
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