Effects of Adding Morphine to Periarticular Infiltration Analgesia Combined with Single Dose Epidural Morphine in Total Knee Arthroplasty: A Randomized Controlled Study

Objective Morphine plays an important role in postoperative analgesia after total knee arthroplasty (TKA). However, there are limited data that investigate the administration ways of morphine. To evaluate the efficacy and safety of adding morphine to periarticular infiltration analgesia (PIA) combin...

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Bibliographic Details
Published in:Orthopaedic surgery 2023-04, Vol.15 (4), p.1021-1027
Main Authors: Li, Yicheng, Wulamu, Wuhuzi, Yushan, Nuerailijiang, Guo, Xiaobin, Gu, Wenchao, Cao, Li, Zhang, Xiaogang
Format: Article
Language:English
Subjects:
Analgesics
Anesthesia
Arthritis
Body mass index
Clinical
Epidural
Epidural Analgesia
Gender
Joint replacement surgery
Knee
Morphine
Narcotics
Pain
Pain management
Periarticular Infiltration Analgesia
Postoperative Pain
Prostheses
Range of motion
Statistical analysis
Surgical outcomes
Total Knee Arthroplasty
Variance analysis
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Summary:Objective Morphine plays an important role in postoperative analgesia after total knee arthroplasty (TKA). However, there are limited data that investigate the administration ways of morphine. To evaluate the efficacy and safety of adding morphine to periarticular infiltration analgesia (PIA) combined with single‐dose epidural morphine for the patients undergoing TKA. Methods In total, 120 patients with knee osteoarthritis who underwent the primary TKA from April 2021 and March 2022 were randomized into three groups (a cocktail containing morphine with single‐dose epidural morphine [Group A]; a cocktail containing morphine [Group B]; and a cocktail free of morphine [Group C]). The three groups were compared based on the Visual Analog Score at rest and during motion, requirement of tramadol, functional recovery including quadriceps strength and range of motion, and adverse events including nausea and vomiting and local and systemic adverse events. The repetitive measure analysis of variance and chi‐square test among three groups were used to analyze the results. Results Analgesia strategy in Group A (0.4 ± 0.8, and 0.9 ± 1.0 points, respectively) significantly reduced rest pain at 6 and 12 h after surgery relative to Group B (1.6 ± 1.2, and 2.2 ± 1.4 points, respectively) (p 
ISSN:1757-7853
1757-7861
DOI:10.1111/os.13637