Combined intra-articular glucocorticoid, bupivacaine and morphine reduces pain and convalescence after diagnostic knee arthroscopy.

Abstract	We studied the effect of intra-articullar saline vs. bupivacaine + morphine or bupivacaine morphine + methylprednisolone after diagnostic knee arthroscopy. In a double-blind randomized study, 60 patients undergoing diagnostic knee arthroscopy without a therapeutic procedure were allocated to groups receiving intra-articular saline, intra-articular bupivacaine 150 mg + morphine 4 mg or the same dose of bupivacaine + morphine + intra-articular methylprednisolone 40 mg at the end of arthroscopy during general anesthesia. All patients were instructed to resume normal activities immediately after the procedure. Pain during movement and walking, leg muscle force and joint effusion, use of crutches and duration of sick leave were assessed. A combination of bupivacaine and morphine reduced pain, duration of immobilization and of convalescence. The addition of methylprednisolone further reduced pain, use of more analgesics, joint swelling and convalescence.
Authors	Sten Rasmussen, Jan S Lorentzen, Allan S Larsen, Søren T Thomsen, Henrik Kehlet
Journal	Acta orthopaedica Scandinavica (Acta Orthop Scand) Vol. 73 Issue 2 Pg. 175-8 (Apr 2002) ISSN: 0001-6470 [Print] England
PMID	12079015 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References	Analgesics, Opioid Anesthetics, Local Glucocorticoids Morphine Methylprednisolone Bupivacaine
Topics	Adult Analgesics, Opioid (administration & dosage, therapeutic use) Anesthetics, Local (administration & dosage, therapeutic use) Arthroscopy (adverse effects) Bupivacaine (administration & dosage, therapeutic use) Convalescence Double-Blind Method Drug Therapy, Combination Female Glucocorticoids (administration & dosage, therapeutic use) Humans Injections, Intra-Articular Knee Joint (drug effects, pathology) Male Methylprednisolone (administration & dosage, therapeutic use) Middle Aged Morphine (administration & dosage, therapeutic use) Pain (etiology, prevention & control) Pain Measurement Time Factors

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