The application of morphine bupivacaine and morphine + bupivacaine by intraarticular injection just after the arthroscopic knee surgery

Abstract

In this study the analgesic effects of morphine, bupivacaine and morphine+bupivacaine applied by intraarticular injection just after the arthroscopic knee surgery were researched. The patients were randomized in 4 groups; to all of the groups drugs were applied by intraarticular injection as follows; 1st, group (n=30) 20ml serum physiologic, 2nd group (n=20) 5mg morphine in 20ml serum physiologic, 3nd group (n=20) 20 ml %0,5 bupivacaine and 4th group (n=20) 5 mg morphine in 20 ml %0.5 bupivacaine. The severity of pain was assessed by visual analog scale (VAS) within 1st, 2nd, 3nd, 4th, 6th and 24th hours. In addition to VAS, analgesic needs of groups in a 24 hours, at first 2 hours (early) and between 6-24 hours (late) periods were determined. According to the findings; in the early postoperative period, the analgesic effect of bupivacaine was good, but morphine was not effective. In the late period, application of bupivacaine and morphine alone, the analgesic effects were inadequate, but in both early and late postoperative periods co-application of bupivacaine and morphine, analgesic effects were sufficient to control the pain.

Özet

Çalışmamızda, artroskropik diz cerrahisi sonrası intraartiküler olarak uygulanan morfin, bupivakain ve morfin+bupivakainin analjezik etkileri incelendi. Olgular gelişigüzel dört gruba ayrıldı. 1. Gruba (n=30) 20 ml serum fizyolojik (SF), 2. Gruba (n+20) 20 ml SF içinde 5 mg morfin. 3. Gruba (n=20) 20 ml bupivakain %0,5 ve 4. Gruba (n=20) 20 ml bupivakain içinde 5 mg morfin intraartiküler olarak verildi. Ağrı, 7, 2, 3. 4. 6, ve 24. saatlerde Visual Analog Skala (VAS) ile değerlendirildi. Ayrıca, grupların 24. ilk 2(erken) ve 6-24 saatlik (geç) analjezik gereksinimleri saptandı. Elde edilen bulgulara göre erken postop dönemde, bupivakain iyi bir analjezi sağlarken, morfin etkisiz kalmıştır. Geç post-op dönemde, bupivakain ve morfinin analjezik etkileri nispeten az olmuştur. Birlikte kullanıldıklarında ise hem erken hemde geç post-op dönemde yeterli bir analjezi sağ-lamışlardır.