Comparison of a Pain Pump Versus Injectable Medication for Analgesia in Knee Arthroscopy

Phase 2

Completed

Interventions: Device: saline pain pump with injectable medication
Drug: ropivacaine, ketorolac , morphine sulfate
Device: pain pump containing ropivacaine

Brief Summary: Hypothesis: Ropivacaine, morphine and ketorolac injected after knee arthroscopy is as effective as this solution plus ropivacaine administered intra-articularly for twenty-four hours.

Three groups were assigned random patients, each group provided a different method of pain medication in order to determine the effectiveness of each treatment.

Detailed Description: Arthroscopic knee patients were randomized to 1 of 3 groups. A) 30mL of ropivacaine (0.5%), 30mg of ketorolac and 8mg of morphine sulfate injected plus a pain pump containing 100mL of ropivacaine (0.5%) administered at 4 mL/hour; B) an identical solution plus a pain pump containing 100-mL of normal saline administered at 4 mL/hour; C) an identical solution and no pain pump. Pain level, the amount of pain medication used and time to discharge were recorded. Clinical and radiographic evaluation was performed at nine months after surgery.

Recruitment & Eligibility

Inclusion Criteria

All subjects who underwent:

Exclusion Criteria

A surgical procedure that required an incision other then an arthroscopic portal
A surgical procedure within the same joint within ninety days
A acute or chronic knee infection
Any diagnosis of complex regional pain syndrome
A known allergy to one of the study drugs
A documented history of narcotic use
A score of less than two standard deviation on the SF-12 mental component
Any major systemic or cardiac illness (heart failure, uncontrolled angina, bifascicular blocks, renal insufficiency, or liver disease)
Under the age of eighteen years

Arm && Interventions

Group	Intervention	Description
saline pain pump , injectable medication	saline pain pump with injectable medication	30mL of ropivacaine (0.5%), 30mg of ketorolac and 8mg of morphine sulfate injected plus a pain pump containing 100-mL of normal saline administered at 4 mL/hour
injectable medication only	ropivacaine, ketorolac , morphine sulfate	30mL of ropivacaine (0.5%), 30mg of ketorolac and 8mg of morphine sulfate injected and no pain pump.
pain pump , injectable medication	pain pump containing ropivacaine	30mL of ropivacaine (0.5%), 30mg of ketorolac and 8mg of morphine sulfate injected plus a pain pump containing 100mL of ropivacaine (0.5%) administered at 4 mL/hour;

Primary Outcome Measures

Name	Time	Method
Pain Score 8 Hours Post-operativley	8 hours post surgery	Visual Analog Scale. The visual analog scale (VAS) is a validated, subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between "no pain" and "worst pain. "no pain" on the left end (0 cm) of the scale and the "worst pain" on the right end of the scale (10 cm).
Pain Scale	72 hours post surgery	Visual Analog Scale. The visual analog scale (VAS) is a validated, subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between "no pain" and "worst pain. "no pain" on the left end (0 cm) of the scale and the "worst pain" on the right end of the scale (10 cm).

Secondary Outcome Measures