Assessment of the effectiveness of peripheral administration of morphine with local articaine anaesthesia for surgery in inflamed oral and maxillofacial tissues

The controversy surrounding clinical trials of peripherally applied morphine with local anaesthetic and the attendant ambiguous results led to a study of our own clinical material. The aim of the study was to assess the effectiveness of peripheral administration of morphine with local articaine anaesthesia in inflamed oral and maxillofacial tissues. Sixty patients who qualified for the randomized, double-blinded study were randomly divided into two groups. Group 'LA' received a standard local anaesthetic solution (articaine plus epinephrine) while group 'LA-Mo' received the standard solution with an addition of 1 mg of morphine. Pain intensity was assessed using the Visual Analogue Scale, before and directly after surgery as well as at 1, 2, 6, 12, 24 and 48 h after completion of surgery. Furthermore, supplemental consumption of the prescribed analgesic was recorded. Despite a very similar average level of initial pain, there was a marked difference between the groups in the pain level during surgery. Moreover, during the next 12 h, there were significant differences observed in the level of pain between both groups. There was also considerable difference between both groups in the time of first analgesic intake and the total amount of analgesic. Our results show that modified local anaesthesia may be of benefit for the relief of operative and post-operative pain and may also help reduce analgesic intake after oral surgery.