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Intra-articular bupivacaine or bupivacaine and morphine after ACL reconstruction.

作者信息

Danieli Marcus Vinicius, Cavazzani Neto Antonio, Herrera Paulo Adilson

机构信息

Hospital Evangélico de Londrina, Londrina, Paraná, Brazil.

出版信息

Acta Ortop Bras. 2012;20(5):258-61. doi: 10.1590/S1413-78522012000500002.


DOI:10.1590/S1413-78522012000500002
PMID:24453613
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3718450/
Abstract

OBJECTIVE: Reconstructive surgery of the ACL is one of the most commonly performed surgeries today and the control of postoperative pain is part of the priorities of the surgeon. Within the arsenal of analgesia we have the intra-articular application of drugs, and the most studied one is bupivacaine with or without morphine. This study compared the application of bupivacaine with or without morphine with a control group after ACL reconstruction with flexor tendon graft. METHODS: Forty-five patients were randomized into three groups: in group I, 20 ml of saline were applied intra-articularly at the end of the surgery; in group II, 20 ml of bupivacaine 0.25%; and in group III, bupivacaine 0.25% associated with 1 mg of morphine. The groups were assessed for degree of pain by the Visual Analog Scale at 6, 24 and 48 hours postoperatively. RESULTS: Group III had less pain at all times, but the pain was not as intense in all groups to the point of needing extra medications beyond the established protocol. CONCLUSION: The intra-articular application of these medications after ACL reconstruction with flexor tendon graft when performed under spinal anesthesia is not useful enough to use regularly. Level of Evidence II, Lesser quality RCT.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ec0/3718450/ecf6d24711a4/aob-20-258-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ec0/3718450/ecf6d24711a4/aob-20-258-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ec0/3718450/ecf6d24711a4/aob-20-258-g01.jpg

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[1]
Intra-articular bupivacaine or bupivacaine and morphine after ACL reconstruction.

Acta Ortop Bras. 2012

[2]
[Intra-articular analgesia after anterior cruciate ligament reconstruction].

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[3]
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[4]
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[5]
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[6]
Comparison of intra-articular analgesics in arthroscopic anterior cruciate ligament reconstruction surgeries: A randomized controlled trial.

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[7]
Pre- and postoperative intra-articular analgesia for arthroscopic surgery of the knee and arthroscopy-assisted anterior cruciate ligament reconstruction. A double-blind randomized, prospective study.

Knee Surg Sports Traumatol Arthrosc. 1997

[8]
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Knee Surg Sports Traumatol Arthrosc. 2011-11-24

[9]
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[10]
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引用本文的文献

[1]
Assessment of The Addition of Epinephrine to Intra-articular Bupivacaine for the Control of Acute Pain in Patients underwent to Anterior Cruciate Ligament Reconstruction.

Rev Bras Ortop (Sao Paulo). 2021-4-19

[2]
Comparison of intra-articular analgesics in arthroscopic anterior cruciate ligament reconstruction surgeries: A randomized controlled trial.

J Anaesthesiol Clin Pharmacol. 2017

[3]
Single-dose intra-articular bupivacaine plus morphine versus bupivacaine alone after arthroscopic knee surgery: a meta-analysis of randomized controlled trials.

Knee Surg Sports Traumatol Arthrosc. 2017-3

[4]
Single-dose intra-articular bupivacaine plus morphine after knee arthroscopic surgery: a meta-analysis of randomised placebo-controlled studies.

BMJ Open. 2015-6-15

本文引用的文献

[1]
A comparison of intraarticular morphine and bupivacaine for pain control and outpatient status after an arthroscopic knee surgery under a low dose of spinal anaesthesia.

Knee Surg Sports Traumatol Arthrosc. 2010-2-4

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Rev Bras Anestesiol. 2002-9

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Arthroscopy. 2009-3

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Anesth Analg. 2008-7

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Intraarticular injection of magnesium sulphate and/or bupivacaine for postoperative analgesia after arthroscopic knee surgery.

Anesth Analg. 2008-5

[6]
Intraarticular analgesia after arthroscopic knee surgery: comparison of neostigmine, clonidine, tenoxicam, morphine and bupivacaine.

Knee Surg Sports Traumatol Arthrosc. 2005-11

[7]
When to inject analgesic agents intra-articularly in anterior cruciate ligament reconstruction: before or after tourniquet releasing.

Arthroscopy. 2004-11

[8]
The efficacy of intra-articular ketamine for postoperative analgesia in outpatient arthroscopic surgery.

Arthroscopy. 2004-3

[9]
Does the type of arthroscopic surgery modify the analgesic effect of intraarticular morphine and bupivacaine? A preliminary study.

Clin J Pain. 2003

[10]
Combined pre- and post-surgical bupivacaine wound infiltrations decrease opioid requirements after knee ligament reconstruction.

Can J Anaesth. 2001-3

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