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Postoperative analgesic effects of a placebo controlled trial of intraarticular morphine sulfate and intraarticular pethidine HCI for patients undergoing anterior cruciate ligament reconstruction using bone patellar graft.


Alet Gerardo C. Hernandez,
Jonathan  G. Dela Cruz,
Jonnel L. Lim

Related Institution

Department of Anesthesiology - St. Luke's Medical Center

Publication Information

Publication Type
Publication Sub Type
Journal Article, Original
Philippine Journal of Anesthesiology
Publication Date
July-December 2004


Background: Postoperative pain is considered the main cause of morbidity after anterior cruciate ligament (ACL) repair Objectives: This study was designed to determine whether a placebo controlled trial of intraarticular (IA) Morphine sulfate and IA Pethidine HCI would provide postoperative pain relief for patients undergoing ACL reconstruction utilizing bone patellar graft Methods: A randomized, double blind, placebo controlled trial of 60 patients, 18-65 years, ASA I and II scheduled for ACL reconstruction were included in the study. Group I received IA Morphine sulfate 3mg (0.015 percent) solution, Group II received IA Pethidine HCI 30mg (0.15 percent) solution and Group III received IA saline 20 cc solution alone. VAS scores were obtained during the 1st, 2nd, 6th and 24th hour after surgery. Analgesic duration, rescue medication consumption, and occurrence of complications were determined Results: VAS score comparisons were analyzed using Kruskal-Wallis Test and Wilcoxons Matched Pairs Signed Rank test which revealed significant differences among all groups. Analgesic duration and 24-hr rescue medication consumption were also analyzed and results also demonstrated significant differences. However, occurrence of complications was not observed in all clinical trial groups Conclusion: We conclude that IA morphine and IA Pethidine HCI have analgesic effects. IA Pethidine HCI has less analgesic effects as compared to IA morphine sulfate. IA morphine sulfate has the longest analgesic duration and lastly, that IA Morphine sulfate and IA Pethidine HCI offer a well tolerated postoperative pain control with no evidence of complications. (Author)


This study was designed to determine whether intraarticular (IA) Morphine Sulfate, IA Pethidine HCI, placebo would provide postoperative pain relief for patients undergoing ACL reconstruction utilizing bone patellar graft. Specific objective of the study were to: (1) Determine if IA Pethidine HCI has the same analgesic effect with IA Morphine sulfate thru visual analog scale (VAS) comparison, (2) Determine analgesic duration for all groups, (3) Compare rescue medication by documenting IV/ Oral NSAID and IV opioid consumption, and (4) Determine occurrence of postoperative complication like nausea, vomiting, pruritus and respiratory depression.


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