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Home / Equine Research Bank / Vet Anaesth Analg / Analgesic efficacy of intra-articular morphine in experiment...
Veterinary anaesthesia and analgesia2010; 37(2); 171-185; doi: 10.1111/j.1467-2995.2009.00521.x

Analgesic efficacy of intra-articular morphine in experimentally induced radiocarpal synovitis in horses.

Abstract: To compare the analgesic effect of intra-articular (IA) and intravenous (IV) morphine in horses with experimentally induced synovitis. Methods: Eight adult horses. Methods: Randomized, observer blinded, double dummy trial with sequential crossover design. Methods: Radiocarpal synovitis was induced by IA injection of lipopolysaccharide on two occasions separated by a 3-week washout period. In one study period horses received treatment IA; morphine IA (0.05 mg kg(-1)) plus saline IV and in the other study period they received treatment IV; saline IA plus morphine IV (0.05 mg kg(-1)). Lameness and pain were evaluated repeatedly by two observers throughout each of the two 168-hour study periods. Pain was evaluated by use of a visual analogue scale of pain intensity (VAS) and a composite measure pain scale (CMPS). Comparison of treatments was performed by analysis of variance with repeated measurements. Significance level was set to p < or = 0.05. Inter-observer agreement and agreement between the VAS and CMPS was assessed by use of the Bland-Altman method. Results: Intra-articular injection of LPS elicited a marked synovitis resulting in lameness and pain. IA morphine resulted in significantly less lameness than IV morphine (p = 0.03). CMPS (p = 0.09) and VAS (p = 0.10) pain scores did not differ significantly between treatments. Inter-observer agreement of the CMPS was classified as good, but only fair for the VAS. Agreement between the two pain scales was considered fair. Conclusions: An analgesic effect of IA morphine was demonstrated by significantly reduced lameness scores. The results support the common practice of including IA morphine in a multimodal analgesic protocol after arthroscopic surgery, although further studies in clinical cases are needed. The employed CMPS had good reproducibility, and was easy to use, but may have limited sensitivity at mild intensity pain.
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Publication Date: 2010-03-17 PubMed ID: 20230568DOI: 10.1111/j.1467-2995.2009.00521.xGoogle Scholar: Lookup
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  • Journal Article
  • Randomized Controlled Trial

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The study investigates and establishes the analgesic efficacy of intra-articular (within the joint) morphine injections in horses suffering from an induced condition of inflamed joint lining (synovitis).

Research Methodology

  • The researchers implement a randomized, observer-blinded, double dummy trial with a sequential crossover design on eight adult horses.
  • Synovitis is chemically induced in the horses’ radiocarpal (wrist) joint through an intra-articular injection of a lipopolysaccharide (a type of toxin).
  • The study is divided into two segments separated by a three-week washout period to ensure no treatment residues influence the next phase.
  • In the first phase, an intra-articular morphine dose (0.05mg per kg of the horse’s weight) and a saline placebo intravenously are administered.
  • The second phase involved injecting saline as a placebo in the joint and administering the morphine dose intravenously.

Evaluation and Measurement

  • Horses’ pain and mobility are assessed consistently by two observers during each 168-hour long study period.
  • The visual analogue scale (VAS) and a composite measure pain scale (CMPS) are the measures used to quantify pain.
  • Analysis of variance with repeated measurements is employed to compare treatments with the bar of statistical significance set at p ≤ 0.05.
  • The Bland-Altman method is used to evaluate inter-observer agreement and the consistency of the VAS and CMPS.

Research Findings

  • An intra-articular injection of lipopolysaccharide (LPS) successfully induces synovitis, leading to lameness and pain in the horses.
  • Intra-articular morphine resulted in significantly lesser degrees of lameness than intravenous morphine (p=0.03).
  • No significant difference was found between treatment methods in terms of CMPS (p=0.09) and VAS (p=0.10) pain scores.
  • The reproducibility of the CMPS was good in terms of inter-observer agreement, though it was only deemed fair for the VAS.
  • The agreement between the two pain scales was also considered fair.

Research Conclusions

  • The study demonstrates that administering morphine directly to the affected joint in horses reduces the symptom of lameness significantly, endorsing the routine use of intra-articular morphine in a diverse pain management procedure following arthroscopic surgery.
  • Despite these promising results, further research in clinical cases is needed to completely validate the approach.
  • The research also found that the CMPS, which was proven to be easy to use and had good reproducibility, may not be adequately sensitive to mild forms of pain.

Cite This Article

APA
Lindegaard C, Thomsen MH, Larsen S, Andersen PH. (2010). Analgesic efficacy of intra-articular morphine in experimentally induced radiocarpal synovitis in horses. Vet Anaesth Analg, 37(2), 171-185. https://doi.org/10.1111/j.1467-2995.2009.00521.x

Publication

Veterinary anaesthesia and analgesia
ISSN: 1467-2995
NlmUniqueID: 100956422
Country: United States
Language: English
Volume: 37
Issue: 2
Pages: 171-185

Researcher Affiliations

Lindegaard, Casper
  • Department of Large Animal Sciences, University of Copenhagen, Højbakkegård Allé 5, Building 8.68. DK-2630 Taastrup, Denmark. cli@life.ku.dk
Thomsen, Maj H
    Larsen, Stig
      Andersen, Pia H

        MeSH Terms

        • Analgesics, Opioid / administration & dosage
        • Animals
        • Carpal Joints
        • Cross-Over Studies
        • Female
        • Horse Diseases / drug therapy
        • Horses
        • Injections, Intra-Articular / veterinary
        • Lameness, Animal / drug therapy
        • Male
        • Morphine
        • Pain / drug therapy
        • Pain / veterinary
        • Synovitis / drug therapy
        • Synovitis / veterinary

        Citations

        This article has been cited 20 times.
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