Intrathecal Morphine for Unilateral Total Knee Arthroplasty

Mahidol University

Status: Completed

Conditions: Primary Osteoarthritis of Knee Nos

Treatments: Procedure: 50 ug IT morphine; Procedure: No IT morphine; Procedure: 100 ug IT morphine; Drug: Morphine; Drug: Bupivacaine

Study type: Interventional

Funder types: Other

Identifiers

NCT03232957

Si 331/2017

Details and patient eligibility

About

This study evaluates postoperative numerical pain score and systemic opioid requirement within 48 hours for unilateral total knee arthroplasty. Comparing among 3 groups of intrathecal morphine; 0,50, 100 ug with multimodal analgesia.

Full description

Intrathecal opioid is effective postoperative analgesia for orthopedic lower extremity surgery. However there are some limitations such as nausea, vomiting, pruritus, dizziness. Nowadays multimodal analgesia is used in unilateral total knee arthroplasty include oral analgesic drugs, adductor canal block and local analgesia infiltration.

This study evaluates whether intrathecal opioid should be added in the role of multimodal analgesia in total knee arthroplasty.

Enrollment: 131 patients

Sex: All

Ages: 18 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Aged more than 18 years old undergoing unilateral total knee arthroplasty
• American Society of Anesthesiologists physical status classification 1-3

Exclusion criteria

• Participants deny to enroll the study
• Allergy to local anesthetics, opioid and NSAIDs
• Hepatic disease
• Contraindication for neuraxial block or adductor canal block
• Uncontrolled cardiovascular disease
• Creatinine clearance less than 50 ml/min

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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131 participants in 3 patient groups

No IT morphine

Experimental group

Description:

Spinal block with 0.5% isobaric with no intrathecal morphine

Treatment:

Drug: Morphine

Procedure: No IT morphine

Drug: Bupivacaine

50 ug IT morphine

Experimental group

Description:

Spinal block with 0.5% isobaric with 50 ug intrathecal morphine

Treatment:

Drug: Morphine

Procedure: 50 ug IT morphine

Drug: Bupivacaine

100 ug IT morphine

Experimental group

Description:

Spinal block with 0.5% isobaric with 100 ug intrathecal morphine

Treatment:

Drug: Morphine

Procedure: 100 ug IT morphine

Drug: Bupivacaine