Epidural Morphine for Postoperative Analgesia After Total Knee Arthroplasty

Summary

Single femoral nerve blockade combined with patient-controlled intravenous analgesia are used for postoperative analgesia for patients after TKA in the hospital of the investigators. Although this method provides acceptable analgesia, the incidence of opioid-associated side effects is relatively high. Low-dose epidural morphine is commonly used in postoperative analgesia after cesarean section, and the effect of single dose morphine lasts more than 20 hours, with low incidences of itching, nausea, vomiting, and respiratory depression. The investigators hypothesize that, for patients undergoing TKA, the addition of low-dose epidural morphine to single femoral nerve block and intravenous opioids can improve the postoperative analgesia, reduce the consumption of intravenous opioids and decrease opioid-associated side effects.

Conditions

• Adult Patients
• Total Knee Arthroplasty
• Epidural Analgesia
• Femoral Nerve Block
• Analgesic Adverse Reaction

Interventions

PROCEDURE

Epidural morphine

2 mg of morphine (0.4 mg/ml morphine in 5 ml normal saline) is administered through the epidural catheter at the end of surgery.

PROCEDURE

Epidural placebo

5 ml normal saline is administered through the epidural catheter at the end of surgery.

PROCEDURE

Single femoral nerve block

Single femoral nerve block is performed with 20 ml 0.5% ropivacaine under the guidance of ultrasonography and nerve stimulator after surgery.

DRUG

Intravenous morphine analgesia

Intravenous morphine analgesia is provided with a patient-controlled analgesia pump which is established with 100 ml of 0.5 mg/ml morphine, programmed to deliver a 2 ml bolus with a lockout interval of 8-10 min and a background infusion of 0.5 ml/h.

Sponsors & Collaborators

• Peking University First Hospital

  lead OTHER

Principal Investigators

• Dong-Xin Wang, MD,PhD · Peking University First Hospital

Study Design

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

QUADRUPLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

90 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2017-07-01

Primary Completion

2018-04-30

Completion

2018-05-30

Countries

• China

Study Locations