Reconstruction of the anterior cruciate ligament: comparison of analgesia using intrathecal morphine, intra-articular morphine and intra-articular levobupivacaine

OBJECTIVE: To compare the analgesic effect of intra-articular administration of morphine and levobupivacaine (separately or in combination) with intrathecal administration of morphine in patients undergoing anterior cruciate ligament (ACL) reconstruction using autologous grafts from the patellar ten...

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Main Authors: Leandro Queiroz Pinheiro, Edmundo Neri Junior, Reginaldo Mendonça Fernandes, Rodrigo Tavares Cardozo, Priscila Rodrigues Rezende
Format: Article
Language:English
Published: Thieme Revinter Publicações Ltda. 2015-06-01
Series:Revista Brasileira de Ortopedia
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162015000300300&lng=en&tlng=en
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author Leandro Queiroz Pinheiro
Edmundo Neri Junior
Reginaldo Mendonça Fernandes
Rodrigo Tavares Cardozo
Priscila Rodrigues Rezende
author_facet Leandro Queiroz Pinheiro
Edmundo Neri Junior
Reginaldo Mendonça Fernandes
Rodrigo Tavares Cardozo
Priscila Rodrigues Rezende
author_sort Leandro Queiroz Pinheiro
collection DOAJ
description OBJECTIVE: To compare the analgesic effect of intra-articular administration of morphine and levobupivacaine (separately or in combination) with intrathecal administration of morphine in patients undergoing anterior cruciate ligament (ACL) reconstruction using autologous grafts from the patellar tendon.METHODS: This was a retrospective analysis on data gathered from the medical files of 60 patients aged 20 to 50 years who underwent knee video arthroscopy for ACL reconstruction. The patients were divided into four groups of 15 individuals (A, B, C and D) according to the agent administered into the joint and around the incision: 20 mL of saline solution with 5 mg of morphine in A; 20 mL of 0.5% levobupivacaine solution in B; 10 mL of solution with 2.5 mg of morphine plus 10 mL of 0.5% levobupivacaine solution in C; and morphine administered intrathecally in D.RESULTS: All the groups presented low pain scores during the first 12 h after the surgery. Groups B and C presented significantly greater pain scores than shown by group D (control), 24 h after the surgery. There was no statistical difference in pain scores between group A and group D.CONCLUSION: The patients in group A presented analgesia comparable to that of the patients in group D, whereas the procedure of group C was no capable of reproducing the analgesic effect observed in group D, as observed 24 h after the surgery. Further studies are needed in order to show the exact mechanism of action, along with the ideal dose and concentration for applying opioids to joints.
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spelling doaj.art-353dbb590f4a4d4f999bb888322f6e362024-04-03T08:56:28ZengThieme Revinter Publicações Ltda.Revista Brasileira de Ortopedia1982-43782015-06-0150330030410.1016/j.rboe.2015.06.002S0102-36162015000300300Reconstruction of the anterior cruciate ligament: comparison of analgesia using intrathecal morphine, intra-articular morphine and intra-articular levobupivacaineLeandro Queiroz PinheiroEdmundo Neri JuniorReginaldo Mendonça FernandesRodrigo Tavares CardozoPriscila Rodrigues RezendeOBJECTIVE: To compare the analgesic effect of intra-articular administration of morphine and levobupivacaine (separately or in combination) with intrathecal administration of morphine in patients undergoing anterior cruciate ligament (ACL) reconstruction using autologous grafts from the patellar tendon.METHODS: This was a retrospective analysis on data gathered from the medical files of 60 patients aged 20 to 50 years who underwent knee video arthroscopy for ACL reconstruction. The patients were divided into four groups of 15 individuals (A, B, C and D) according to the agent administered into the joint and around the incision: 20 mL of saline solution with 5 mg of morphine in A; 20 mL of 0.5% levobupivacaine solution in B; 10 mL of solution with 2.5 mg of morphine plus 10 mL of 0.5% levobupivacaine solution in C; and morphine administered intrathecally in D.RESULTS: All the groups presented low pain scores during the first 12 h after the surgery. Groups B and C presented significantly greater pain scores than shown by group D (control), 24 h after the surgery. There was no statistical difference in pain scores between group A and group D.CONCLUSION: The patients in group A presented analgesia comparable to that of the patients in group D, whereas the procedure of group C was no capable of reproducing the analgesic effect observed in group D, as observed 24 h after the surgery. Further studies are needed in order to show the exact mechanism of action, along with the ideal dose and concentration for applying opioids to joints.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162015000300300&lng=en&tlng=enMorfinaArtroscopiaLigamento cruzado anteriorAnestesia
spellingShingle Leandro Queiroz Pinheiro
Edmundo Neri Junior
Reginaldo Mendonça Fernandes
Rodrigo Tavares Cardozo
Priscila Rodrigues Rezende
Reconstruction of the anterior cruciate ligament: comparison of analgesia using intrathecal morphine, intra-articular morphine and intra-articular levobupivacaine
Revista Brasileira de Ortopedia
Morfina
Artroscopia
Ligamento cruzado anterior
Anestesia
title Reconstruction of the anterior cruciate ligament: comparison of analgesia using intrathecal morphine, intra-articular morphine and intra-articular levobupivacaine
title_full Reconstruction of the anterior cruciate ligament: comparison of analgesia using intrathecal morphine, intra-articular morphine and intra-articular levobupivacaine
title_fullStr Reconstruction of the anterior cruciate ligament: comparison of analgesia using intrathecal morphine, intra-articular morphine and intra-articular levobupivacaine
title_full_unstemmed Reconstruction of the anterior cruciate ligament: comparison of analgesia using intrathecal morphine, intra-articular morphine and intra-articular levobupivacaine
title_short Reconstruction of the anterior cruciate ligament: comparison of analgesia using intrathecal morphine, intra-articular morphine and intra-articular levobupivacaine
title_sort reconstruction of the anterior cruciate ligament comparison of analgesia using intrathecal morphine intra articular morphine and intra articular levobupivacaine
topic Morfina
Artroscopia
Ligamento cruzado anterior
Anestesia
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162015000300300&lng=en&tlng=en
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