Intraarticular fentanyl compared with morphine for pain relief following
arthroscopic knee surgery.
Author(s): Varkel V, Volpin G, Ben-David B, Said R, Grimberg B, Simon K, Soudry M.
Affiliation(s): Department of Anesthesia, Western Galilee Hospital, Nahariya, Israel.
Publication date & source: 1999, Can J Anaesth. , 46(9):867-71
PURPOSE: To compare the analgesia produced by comparable doses of intra-articular
(IA) morphine and fentanyl.
METHODS: Sixty-nine healthy patients undergoing arthroscopic surgery received a
standardized general anesthetic of 4 mg x kg(-1) thiopental and 2 microg x kg(-1)
fentanyl followed by 2 mg x kg(-1) succinylcholine prior to tracheal intubation
and controlled ventilation. Maintenance of anesthesia was achieved with N2O/O2
and isoflurane. At the conclusion of surgery intra-articular injection was: Group
I (n=23) 50 microg fentanyl in 20 ml saline; Group II (n=24) 3 mg morphine in 20
ml saline; Group III (n=22) 20 ml saline. Pain scores at rest using a visual
analogue scale were recorded by a separate blinded observer at one, two, four,
and eight hours postoperatively.
RESULTS: Pain scores at one, two, four, and eight hours were 36, 26.3, 20.9, and
12.8 vs 35.8, 33.8, 28.8, and 21.9 vs 70.5, 57.7, 58.4, and 53.6 for the
IA-fentanyl, IA-morphine, and control groups respectively. Pain scores were
greater at all times for Group III. Pain scores for Groups I and II were similar
at one hour, but thereafter were less (P < 0.001) for the IA-fentanyl group.
CONCLUSION: Better postoperative analgesia was achieved with 50 microg
intraarticular fentanyl than with 3 mg intraarticular morphine.
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