Intrathecal Morphine Effects in Knee Arthroplasty Patients Receiving Spinal Anesthesia, Distal Femoral Triangle Block and Periarticular Infiltration: A Retrospective Cohort Study
Keywords:
Intrathecal morphine, Distal femoral triangle block, Knee arthroplasty, Postoperative painAbstract
Background: Knee osteoarthritis (OA knee) is one of the major causes of pain, disability and activity limitation in elderly. Although knee arthroplasty eases the suffering in the long run, moderate to severe pain is commonly experienced in early postoperative phase. There are many options to lessen this pain. The aim of this study is to study the effects of intrathecal morphine in knee arthroplasty patients receiving spinal anesthesia, distal femoral triangle block and periarticular infiltration. Objective: To evaluate effects of intrathecal morphine on incidence of postoperative moderate to severe pain in knee arthroplasty patients receiving spinal anesthesia, distal femoral triangle block and periarticular infiltration. Method: Retrospective cohort study was done in 205 communicable patients (n = 205) who underwent knee arthroplasty under spinal anesthesia, distal femoral triangle block and periarticular infiltration in Rajavithi 2 (Rangsit) Hospital from July 2023 to July 2024. Data collected were demographic data, site and type of operation, operation time, intrathecal morphine, max numeric rating pain score (NPRS) in first 18 hours post operation, type of postoperative analgesia both around the clock and recruitment, and time to first recruitment analgesia. Results: Incidence of moderate to severe pain in patients underwent knee arthroplasty under spinal anesthesia, distal femoral triangle block and periarticular infiltration is 20 percent. Patients, who received intrathecal morphine, experienced moderate to severe pain 10.2% which is statistically less than those who did not receive (39.7%). Conclusion: Intrathecal morphine is able to decrease incidence of moderate to severe pain in patients underwent knee arthroplasty under spinal anesthesia, distal femoral block and periarticular infiltration. However, the downside is more nausea/ vomiting.
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