• M McSwiney, J Cooper, S Karadia, and M Campbell.
• Department of Anaesthesia, Cheltenham General Hospital, UK.
• Acta Anaesthesiol Scand. 1997 Mar 1; 41 (3): 345-7.

BackgroundWe hypothesised that any peripheral action of morphine may contribute to improved postoperative analgesia. The aim of this study was to evaluate the analgesic efficacy of morphine administered preoperatively into an exsanguinated limb prior to total knee arthroplasty.MethodsA randomised, double-blind, controlled study was performed in 50 patients having total knee arthroplasty surgery. Patients were divided into two groups. In the study group, 0.125 mg/kg morphine in 60 ml of saline was administered intravenously (iv) into the exsanguinated operative limb via a cannula in the foot. A saline intramuscular (im) injection was administered into the opposite leg. The control group received 60 ml saline iv into the operative leg and 0.125 mg/kg morphine im into the opposite leg. Pain was assessed postoperatively using a 10-point visual analogue scale and by comparing morphine requirements and demand:delivery ratios from a patient-controlled analgesic pump.ResultsWe found no statistically significant difference between the groups in relation to any of the analgesic measures employed.ConclusionsIntravenous regional analgesia using morphine provides no analgesic advantage over the intramuscular route from 6-24 h postoperatively.

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