Pain Treatment After Total Knee Replacement - Continuous Epidural Versus Intravenous Patient Controlled Analgesia With Morphine
The study purpose is to compare the effectiveness of different methods for post-operative pain treatment after total knee replacement.
Drug: Marcaine 0.166% + Fentanyl 3.33 mcg/ml
Drug: Morphine sulphate
|Study Design:||Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Primary Purpose: Treatment
|Official Title:||Pain Treatment After Total Knee Replacement - Continuous Epidural Versus Intravenous Patient Controlled Analgesia With Morphine|
- Visual analog scale (VAS) (rest/movement) during first 24 hours post-operation
- Total dose of rescue analgesics during first 24 hours post-operation
- VAS (rest/movement) + total dose rescue analgesics after 24 hours post-operation until discharge
- Patient outcome questionnaire
- Physiotherapy performance VAS (rest/walking, passive extension, maximal angle, knee flexion/extension)
- Adverse reactions, complications
|Study Start Date:||January 2006|
|Study Completion Date:||March 2007|
Total knee replacement (TKR) is known to be one of the most painful surgical procedures. Many treatments have been used post TKR: IV opioids, epidural infusions, peripheral nerve blocks. No one method has been recognised as the best one.
In this study we will compare two well established methods of pain treatment:
- continuous infusion of local anesthetics + opioids into the epidural space,
- patient controlled analgesia with IV Morphine.
The study design is double blind.
Patients will have a combined spinal-epidural anesthesia for the operation and then will be connected to 2 different pumps, one to the epidural catheter and one to the intravenous catheter, for the first 24 hours post-operatively.
Pain scores, total analgesic medications other than study medications, adverse reactions to study medications, complications and patient satisfaction will be followed by blinded observers and compared between groups.