J Korean Foot Ankle Soc.  2013 Jun;17(2):93-99.

Usefulness of Morphine in the Periarticular Multimodal Drug Local Injection after Surgery for Hallux Valgus

• Cho JH
• Choi HJ
• Kim YM
• Kim JY
• Wang BG
• Lee WC

Abstract

PURPOSE
Proximal metatarsal chevron osteotomy for hallux valgus is followed by significant amount of postoperative pain. Periarticular multimodal drug local injection can be an option for pain control. This study was attempted to evaluate the efficacy of the morphine as multimodal drug and to confirm the effect of periarticular multimodal drug local injection on controlling early postoperative pain.
MATERIALS AND METHODS
Between March 2012 and June 2012, 22 patients received proximal metatarsal chevron osteotomy for the correction of hallux valgus deformity. 10 patients (Group A) received periarticular injection of the test solution made with morphine, ropivacaine, ephinephrine and ketorolac. 12 patients (Group B) received periarticular injection of the test solution without morphine. The visual analog scale (VAS) was checked at 2, 4, 6, 8 hours, 1 day and 2 days each after surgery.
RESULTS
The VAS score at postoperative 2 hours to 1 day between two groups showed no significant difference, but the VAS score at postoperative 2 days was significantly higher in Group A compared to the VAS score of group B. The amount of additional pain control (tramadol HCL) between two groups showed no significant difference for 3 days after surgery.
CONCLUSION
Periarticular multimodal drug local injection was effective in reducing pain after hallux valgus surgery regardless of mixing with morphine.

Keyword

Hallux valgus; Periarticular injection; Multimodal drug; Morphine

MeSH Terms

Amides
Congenital Abnormalities
Hallux
Hallux Valgus
Humans
Ketorolac
Metatarsal Bones
Morphine
Osteotomy
Pain, Postoperative
Amides
Ketorolac
Morphine