The Effects of Intraarticular Opioids in pain relief after Arthroscopic Menisectomy: A Randomized Clinical Trial Study

Abstract

Objective: Knee arthroscopy is a painful procedure which if untreated will cause intensive and prolonged pain that may prevent rehabilitation of patients. This study was designed to compare the analgesic effects of different opioids in the early post operative period in comparison to control group.

Methodology: One hundred forty patients were prospectively assigned to four groups randomly. After arthroscopic menisectomy all patients received an intraarticular injection containing 9.5 ml bupivacaine 0.5% with 1:200000 epinephrine in a 10 ml syringe. The remainder of syringe was filled with one of the study solutions. Group I: 5mg methadone, group II: 5mg morphine, group III: 5 ml normal saline, group IV: 50 mg meperidine. At three stages in the ealy post operative period the need for analgesics was recorded. A statistical comparison was done afterwards. Results : In morphine group (group II), the analgesic usage in hospitalized and outpatients compared with other groups was significantly low(P<0.05).

Conclusion: Morphine in comparison to meperidine or methadone is more beneficial in reducing pain or analgesic need when is added to bupivacain injection following arthroscopic menisectomy.

Keywords: Arthroscopy; Intraarticular Analgesia; Meperidine; Methadone; Morphine.