The American journal of sports medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of intraarticular morphine and bupivacaine for pain control after outpatient knee arthroscopy. A prospective, randomized, double-blinded study.
To determine the duration of pain relief and efficacy of intraarticular morphine compared with bupivacaine after outpatient knee arthroscopy under local anesthesia, we gave patients one of three postoperative intraarticular injections: 4 mg morphine, 0.25% bupivacaine, or 0.9% saline. Visual analog scale scores and supplemental pain medication use were recorded at 0 to 30 minutes, 2, 4, 6, 8 to 12, and 24 hours after surgery. The score on the visual analog scale at 24 hours was significantly lower in the morphine group than in the bupivacaine or control groups. ⋯ The morphine group used the least supplemental pain medication during the 12 to 24 hour interval (P = 0.06). We found that the use of intraarticular morphine or bupivacaine after outpatient knee arthroscopy will decrease the amount of narcotic medication needed for pain relief during the early postoperative period. In addition, morphine provided prolonged pain relief up to 24 hours when compared with bupivacaine or placebo, and the patients in the morphine group tended to take less supplemental pain medication during the first postoperative day.
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Anterior shoulder dislocation is a common skiing injury. Several methods are available for reduction of shoulder dislocations. We evaluated a method for reduction of anterior shoulder dislocation that has not previously appeared in the literature. ⋯ The physician applies traction to the affected shoulder using downward pressure on a loop of stockinette wrapped around the patient's forearm. Our method was successful in 97% of 118 anterior dislocations with no complications. Ninety-three percent were performed without the use of narcotic analgesia.