Analgesic effect of intra-articular ketorolac in knee arthroscopy:: comparison of morphine and bupivacaine

This prospective study assessed the postoperative analgesic effect of intra-articular ketorolac, morphine, and bupivacaine during arthroscopic outpatient partial meniscectomy. Group 1 patients (n = 20) received postoperative injection of 60 mg intra-articular ketorolac, group 2 patients (n = 20) 10 cc intra-articular bupivacaine 0.25%, group 3 patients (n = 20) 1 mg intra-articular morphine diluted in 10 cc saline, and group 4 patients (n = 20, controls) only 10 cc saline. We evaluated the postoperative analgesic effect ( period measured from the end of the surgery until further analgesia was demanded), the level of postoperative pain ( by visual analog scale 1, 2, 3, 12, and 24 h after surgery), and the need for additional pain medication ( during the first 24 h after surgery). The best analgesic effect was in patients treated with intra-articular ketorolac, and this was statistically significant in: postoperative analgesic effect and the need for additional pain medication immediately after surgery, and after 24 h. No complications were found related to the intra-articular treatment. We conclude that 60 mg intra-articular ketorolac provides better analgesic effect than 10 cc intraarticular bupivacaine 0.25% or 1 mg intra-articular morphine.