41 patients scheduled to undergo total knee arthroplasty (TKA) were randomized to undergo the procedure with spinal anaesthesia with our without the addition of epimorph. The purpose of this study was to determine if the addition of epimorph to spinal anaesthesia yielded significantly greater pain control and decreased consumption of narcotics without increasing postoperative complication rates. Outcomes were assessed up one week postoperatively, and consisted of the visual analogue scale (VAS) for pain, narcotic use, Foley insertion, oxygen requirements, nausea, vomiting, and pruritus. Findings indicated higher VAS pain scores and similar narcotic consumption, as well as greater incidence of nausea and pruritus were reported in the spinal epimorph group compared to the spinal-only group.