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Intraosseous morphine added to standard antibiotic solution offers pain relief immediately after total knee arthroplasty (TKA), according to a study recently published in the Journal of Arthroplasty.
Ava A. Brozovich, M.P.H., from the Texas A&M Health Science Center College of Medicine in Bryan, and colleagues conducted a double-blind, randomized controlled trial on 48 consecutive patients undergoing primary TKA. The control group received an intraosseous injection of antibiotics, per standard protocol, and the experimental group received an intraosseous antibiotic injection with morphine.
The researchers found that at one, two, three, and five hours postoperatively, the experimental group had lower Visual Analog Scale pain scores. For postoperative days 1, 2, 8, and 9, this trend continued. Lower opioid consumption was seen for the experimental versus control group for the first 48 hours and second week after surgery. The experimental group also showed significant improvement in the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement scores at two and eight weeks after surgery. Compared with the control group, serum morphine levels were significantly lower in the experimental group at 10 hours after the intraosseous injections.
"Intraosseous infusion, which involves injecting medication directly into the bone marrow, allows us to control pain preemptively so that patients don't have to take as much pain medicine later on," a coauthor said in a statement.
One or more authors disclosed financial potential or pertinent conflicts of interest with an entity in the biomedical field.