Randomized Double-Blind Controlled Trial Comparing 0.2 mg and 0.1 mg Intrathecal Morphine Combined with Intravenous Paracetamol Infusion for Unilateral Total Knee Arthroplasty
Keywords:
Total Knee Arthroplasty, Paracetamol, Intrathecal, Morphine, Postoperative pain, Side effectsAbstract
Objective : To compare the efficacy of postoperative unilateral total knee arthroplasty pain reduction and the side effects of intrathecal morphine 0.1 mg and 0.2 mg with intravenous paracetamol infusion.
Methods : This randomized double-blind controlled trial was conducted at Krathumbaen Hospital. Patients undergoing total knee arthroplasty were randomized into 2 groups : Intrathecal morphine 0.1 mg (M1) and 0.2 mg (M2). All patients received intravenous paracetamol infusion. Postoperative pain scores, side effects of intrathecal morphine, and patient satisfaction were compared.
Results : The trial enrolled 50 patients : M1 (n = 25) and M2 (n = 25). The postoperative pain scores and rescue analgesic consumption of group M1 and M2 did not differ significantly within 6-48 hours. Postoperative nausea and vomiting in whom did not receive tramadol were observed more frequently in group M2 than M1 within 6 hours (52% and 16% respectively; p-value = 0.02) and within 6-24 hours (28% and 4% respectively; p-value = 0.04). Postoperative pruritus was observed more frequently in group M2 than M1 within 6 hours (44% and 12% respectively; p-value = 0.02). Respiratory depression was not observed in any participant in this study. Patient satisfaction did not differ significantly.
Conclusion : Postoperative pain control achieved with intravenous paracetamol infusion combined with intrathecal morphine 0.1 mg after unilateral total knee arthroplasty was effective. The frequency of postoperative nausea and vomiting and pruritus were also lower.
Keywords : Total Knee Arthroplasty, Paracetamol, Intrathecal, Morphine, Postoperative pain, Side effects
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