JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL

Intraarticular morphine and bupivacaine reduces postoperative pain after rotator cuff repair

J E Tetzlaff, J Brems, J Dilger
Regional Anesthesia and Pain Medicine 2000, 25 (6): 611-4
11097669

BACKGROUND AND OBJECTIVES: To determine whether intraarticular injection of morphine, fentanyl, or sufentanil added to bupivacaine provided pain control after open rotator cuff repair.

METHODS: These data were collected as a prospective, randomized, blinded observer study. All patients received a standard interscalene anesthetic with 1.4% mepivacaine with 1:200,000 epinephrine. At the conclusion of surgery, they received an intraarticular injection after the shoulder capsule was closed. Patients were randomized into 4 groups. All received 20 mL of 0.25% bupivacaine: group 1, plain; group 2, with 1 mg of morphine added; group 3, with 50 microg of fentanyl added; and group 4, with 10 microg of sufentanil added. Pain scores in the postanesthesia care unit were evaluated at 0, 30, 60, 90, 120, and 240 minutes and at 4-hour intervals postoperatively using a visual analogue scale. Breakthrough pain was managed with morphine, via patient controlled analgesia pump.

RESULTS: Thirty-nine patients were entered into the study. Pain scores at 2 hours and beyond were lowest in group 2. Total morphine utilization was significantly lower for the first 24 hours in group 2.

CONCLUSIONS: Intraarticular injection of the shoulder with 0.25% bupivacaine and 1 mg morphine at the conclusion of surgery provided pain control and diminished morphine used in the first 24 hours after open rotator cuff repair. Fentanyl and sufentanil did not improve the analgesia over that achieved with bupivacaine alone.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read
11097669
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.