Sixty patients who were scheduled to have an elective total hip or knee
arthroplasty were randomly assigned to one of three groups of twenty
patients each before operation with spinal anesthesia. A double-blind
technique was used throughout the study. The patients in Group I (control
group) received hyperbaric 1 per cent tetracaine with epinephrine as the
subarachnoid spinal anesthetic; the patients in Group II (morphine group),
hyperbaric 1 per cent tetracaine with epinephrine and a single subarachnoid
dose of Duramorph (morphine sulphate), 0.5 milligram; and those in Group
III (Dilaudid group), hyperbaric 1 per cent tetracaine with epinephrine and
a single subarachnoid dose of Dilaudid (hydromorphone hydrochloride), 0.002
milligram per kilogram of body weight. During the first twenty-four hours
after the operation, the patients in Group II and Group III had
significantly less pain compared with those in Group I. This was shown by
the use of a visual linear-analog pain scale (p less than 0.05), the
patients' ratings of the quality of relief of pain (p less than 0.02), and
comparative measurements of the pain-altering medications that were used (p
less than 0.05). The patients in Group II and Group III did not have any
more complications or side effects than those in Group I. There was no
significant difference in the quality and duration of analgesia between
Group II and Group III.