INTRA-ARTICULAR BUPIVACAINE PLUS MORPHINE VERSUS BUPIVACAINE ALONE FOR LOCAL ANESTHESIA IN KNEE ARTHROSCOPY

Abstract

Background: For knee arthroscopy under local anesthesia, the lowest anesthetic concentration with a less chondrotoxic and good analgesic potency should be chosen. Purpose: The aim of the study was to compare the results in patients where knee arthroscopy under local anesthesia was conducted using intra-articular injection of bupivacaine plus morphine versus bupivacaine alone. Methods: The study included 24 patients with a mean age of 27 years undergoing knee arthroscopy under local anesthesia because of meniscus, cartilage and anterior cruciate ligament injury or synovial plica syndrome. Patients were divided into two groups: Group B where local anesthesia was performed using 20ml of 0.5% bupivacaine with adrenaline for intra-articular application, and Group BM where local anesthesia with intra-articular application of 10ml of 0.5% bupivacaine with adrenaline plus 4mg morphine was used. Intra-operative and post-operative pain as well as pain during treatment of different knee pathologies were evaluated using visual analog scale (VAS). Side effects, patients’ satisfaction and time for rescue analgesia were also recorded. Results: Patients from group BM had significantly lower mean VAS values than those from group B after 5 (p=0.000) and after 9 (p=0.02) hours from the surgery. The time for rescue analgesia was significantly longer in patients from group BM compared to those from group B (p=0.012). There was no significant difference between groups according to the patients’ subjective satisfaction and side effects occurrence. CONCLUSION: Solution of bupivacaine plus morphine was more effective than solution of higher concentration of bupivacaine obtaining better postoperative analgesia reducing the risk for chondrotoxicity.