Comment on: Effects of morphine on peri-articular infiltration analgesia in total knee arthroplasty: a prospective, double-blind, randomized controlled trial

Excerpt

We read with great interest the recent study by Wang et al. [1], “Effects of morphine on peri-articular infiltration analgesia in total knee arthroplasty: a prospective, double-blind, randomized controlled trial.” The authors concluded that “Adding morphine into the analgesic cocktail of peri-articular infiltration analgesia could reduce post-operative morphine consumption in total knee arthroplasty patients, but does not improve early pain relief or accelerate functional recovery or provide clinical benefits for total knee arthroplasty patients.” We agree that managing post-surgical pain is critical to patient recovery and relying on opioids is suboptimal, due to not only opioid-related adverse events but also the risk that short-term exposure can lead to chronic use. We also agree that local infiltration is important to multimodal analgesia, which can reduce the need for opioids, and that the duration of traditional local anaesthetics does not match the duration of acute post-surgical pain. The article is scientifically sound and well structured. However, there are few comments I would like to put forth, which I believe are pertinent to the subject of this study. …