Increased numbers of opioid expressing inflammatory cells do not affect intra-articular morphine analgesia

Title

Increased numbers of opioid expressing inflammatory cells do not affect intra-articular morphine analgesia

Creator

Likar R; Mousa SA; Philippitsch G; Steinkellner H; Koppert W; Stein C; Schafer M

Identifier

Publisher

British Journal Of Anaesthesia

Date

2004

Subject

Female; Humans; Male; Adult; Analgesics; Aged; Middle Aged; Drug Therapy; Double-Blind Method; Biomarkers of Pain; Injections; Dose-Response Relationship; Drug; Opioid/administration & dosage; Receptors; Arthroscopy; Intra-Articular; Morphine/administration & dosage; Pain Measurement/methods; Combination; Knee Joint/metabolism/surgery; Opioid/metabolism; Pirinitramide/administration & dosage; Synovitis/metabolism/pathology

Description

BACKGROUND: Both locally expressed beta-endorphin (END) and low doses of morphine relieve pain within inflamed knee joints. Here we examined whether enhanced inflammation and END expression within the synovial tissue of patients undergoing arthroscopic knee surgery might shift the analgesic dose-response curve of intra-articular (i.a.) morphine. METHODS: Following IRB approval and informed consent, patients were randomly assigned to the following i.a. treatments at the end of surgery: group I (n=39), isotonic saline; group II (n=40), 1 mg morphine hydrochloride; group III (n=48), 2 mg morphine hydrochloride; group IV (n=39), 4 mg morphine hydrochloride. Postoperative pain intensity was assessed by the visual analogue scale (VAS), by the time to first analgesic request and by the supplemental piritramide consumption. Synovial specimens from each patient were stained for the presence of inflammatory cells and END and were discriminated into groups with low versus high numbers of these cells. Differences between groups were statistically analyzed by chi(2), anova and mancova where appropiate. RESULTS: Patient characteristics and VAS scores did not differ between groups. Total postoperative piritramide consumption decreased and the time to first analgesic request increased significantly with increasing doses of i.a. morphine (P0.05, mancova). CONCLUSIONS: The dose-response relationship of i.a. morphine analgesia is not shifted by enhanced inflammation and END expression within synovial tissue. Thus, the presence of END within inflamed synovial tissue does not seem to interfere with i.a. morphine analgesia.
2004

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

375-380

Issue

3

Volume

93

Citation

Likar R; Mousa SA; Philippitsch G; Steinkellner H; Koppert W; Stein C; Schafer M, “Increased numbers of opioid expressing inflammatory cells do not affect intra-articular morphine analgesia,” Pediatric Palliative Care Library, accessed October 16, 2021, https://pedpalascnetlibrary.omeka.net/items/show/12859.

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