Chondrotoxic effect of intraarticular bupivacaine administration

Excerpt

We read the article “The comparison of intraarticular morphine-bupivacaine and tramadol-bupivacaine in postoperative analgesia after arthroscopic anterior cruciate ligament reconstruction” by Hosseini et al. [5] recently published in this journal with great interest. The article describes a randomised, double blind, controlled trial study of ASA I–II patients undergoing arthroscopic ACL reconstruction performed under general anaesthesia who were given a combination of drugs intraarticularly for postoperative analgesia and pain control. Study was approved by the research ethics committees in Shahid Sadoughi University of Medical Sciences, and written informed consents were obtained from 60 male patients. Patients were randomly allocated into three groups. The MB group (n = 20) received 10 mg morphine and 0.5 % bupivacaine, the TB group (n = 20) received 100 mg tramadol and 0.5 % bupivacaine and the control group (n = 20) received 20 ml of isotonic saline intraarticularly at the end of the operation. The authors concluded that intraarticular morphine–bupivacaine combination provides more effective pain relief, longer analgesic duration, less supplemental analgesic postoperative requirements, shorter unassisted ambulation and discharge time when compared to intraarticular tramadol–bupivacaine injection and isotonic saline after ACL reconstruction arthroscopy. In side effects assesment, none of the patients had respiratory depression, and there was no significant difference between the groups in terms of nausea and vomiting. …