Preemptive intraarticular tramadol for pain control after arthroscopic knee surgery

Tuncer, Bilge; Babacan, C. A.; Arslan, M

doi:10.1016/j.rapm.2004.07.205

Cited by 6 publications

(12 citation statements)

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“…In these studies, intra-articular injection of tramadol, morphine, fentanyl, bupivacaine, and prilocaine before operation has been remarkably effective in pain reduction after knee arthroscopy. [341415] Both the results of the present study and the results of the above studies indicated the increased effectiveness of preemptive method in controlling postoperative pain.…”

Section: Discussionsupporting

confidence: 71%

Preemptive analgesia with intra-articular pethidine reduces pain after arthroscopic knee surgery

et al. 2013

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Background:Postoperative pain relief is important in procedures of the lower extremity. Several previous studies have evaluated the efficacy of intra-articular (IA) pethidine as a compound, which has local anesthetic and opioid agonist properties, on postoperative pain relief in arthroscopic knee surgery (AKS). This study compared the postoperative analgesic effect of pre- and post-surgical IA pethidine administration in AKS.Materials and Methods:Seventy-five patients of American Society of Anesthesiologists (ASA) I and II undergoing AKS with general anesthesia were enrolled in this double-blind study. Patients were randomized in three equal groups to receive either 50 mg IA pethidine before surgical incision incision and saline after skin closure (PS), saline before surgical incision and pethedine after skin closure (SP), and only saline at two different times (SS). In each patient with operated knee joint, pain at rest and joint movement was evaluated at 1, 2, 6, 12, and 24 h after surgery completion using Visual Analog Scale (VAS). Data were analyzed using analysis of variance (ANOVA)-repeated measure, t-paired, and Chi-square tests.Results:Postoperative pain score at rest and joint movement in PS group was significantly lower than those in other groups. The time (Mean ± SD) between completion of operation and patient's request for morphine, total morphine consumption (Mean ± SD) in postoperative 24 h, and the numbers of patients requesting analgesic in PS, SP, SS, groups were: 5.2 ± 1.3, 3.3 ± 1.5, and 2 ± 1.3 h (P < 0.05); 4.4 ± 2.4, 8.7 ± 2, and 11.6 ± 4.4 mg (P < 0.05); 11, 18, and 21 persons (P < 0.05), respectively.Conclusion:The present study shows that preemptive intra-articular pethidine 50 mg injection is more effective than preventive injection for postoperative pain relief at rest and joint movement in arthroscopic knee surgery.

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Section: Discussionsupporting

confidence: 71%

Preemptive analgesia with intra-articular pethidine reduces pain after arthroscopic knee surgery

et al. 2013

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“…On quantitative analysis there was a significant reduction in visual analogue scale (VAS) score (WMD = −0.77; 95% CI = −1.30 to −0.24; I 2 = 63%; P = 0.004). In the 2–6 h post‐surgery there was conflicting evidence, with three studies showing a significant reduction and two studies showing no significant difference in pain scores . On quantitative analysis of the three studies using VAS scores there was a significant reduction in pain scores (WMD = −0.92; 95% CI = −1.28 to −0.56; P < 0.00001), with significant heterogeneity ( I 2 = 90%; P < 0.00001).…”

Section: Resultsmentioning

confidence: 98%

“…All six studies measured pain scores post‐knee arthroscopy. Four of the six studies measured pain scores at ≤1 h . On qualitative analysis there was high‐level evidence with all studies showing a significantly lower pain score in the tramadol group.…”

Section: Resultsmentioning

confidence: 98%

Tramadol as an adjunct to intra‐articular local anaesthetic infiltration in knee arthroscopy: a systematic review and meta‐analysis

Ryan

Hodge

Holyoak

et al. 2019

ANZ Journal of Surgery

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Background Arthroscopic knee surgery is a common technique used in Australia. Post‐operative pain is common and can lead to delayed discharge and impair early mobilization. Use of local anaesthesia can reduce pain while avoiding systemic side effects. This systematic review and meta‐analysis aimed to establish the use of tramadol as an adjunct to intra‐articular local anaesthetic infiltration in knee arthroscopy in the current literature. Methods Two independent reviewers performed a systematic search of four databases, where 24 articles were identified with six studies (four high‐quality and two low‐quality randomized controlled trials), with a total of 334 patients were included for analysis. RevMan 5.3 software (The Nordic Cochrane Centre, Copenhagen, Denmark) was used to perform the data analysis. The studies included focused on outcomes such as pain scores, breakthrough analgesia, total analgesia, time to discharge and adverse events related to the use of tramadol as an adjunctive therapy. Results This study found that using tramadol as an adjunct to intra‐articular local anaesthetic infiltration in arthroscopic knee surgery reduced post‐operative pain and increased time to breakthrough analgesia without an increase in side effects. Conclusion This meta‐analysis suggests that tramadol is an efficacious adjunct for use in intra‐articular local anaesthetic infiltration following arthroscopic knee surgery.

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“…Senthilkumaran et al [30] demonstrated that IA combination of 10 mg of morphine and 20 mL of 0.5% bupivacaine reduces requirement for systemic opiate analgesia after arthroscopic ACL reconstruction than morphine alone does. Boden et al [26] and McSwiney et al [31] used IA morphinebupivacaine combination versus saline as control group and reported significantly lower supplementary analgesia and lower analgesic requirements, respectively. In our study, total analgesic consumption was significantly lower in our local anesthetic with tenoxicam and morphine group compared to saline group, which was in accordance with the mentioned studies.…”

Section: Discussionmentioning

confidence: 99%

Analysis of extra articular proximal third tibial fractures treated with interlocked intramedullary nailing

Kumar¹,

Vijay²,

Rathi³

et al. 2017

Int. J. Orthop. Sci.

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Background: Arthroscopic ACL reconstruction surgery is commonly performed as an outpatient procedure and is often associated with postoperative pain. Objectives: We aimed to find out the effects of intra-articular ropivacaine-morphine on postoperative pain in patients undergoing elective arthroscopic ACL reconstruction surgery. Materials and Methods: A total of 46 patients undergoing elective arthroscopic ACL reconstruction under spinal anaesthesia were enrolled. The participants were allocated to two groups to receive the following intra-articular medications after completion of the surgery and before deflation of the tourniquet: Group I, 20 mL of saline, Group II, 0.25% Ropivacaine and 5 mg morphine 20 mL in volume. Visual analogue scale (VAS) values were recorded at 1, 3, 6, 12 and 24 hours postoperatively, duration of analgesia, total analgesic consumption, and number of rescue analgesia at 24 hours were evaluated. Results: VAS was significantly higher in group I in comparison to other groups. Duration of analgesia was significantly longer in Group II than in Group I. Number of rescue analgesia and total analgesic consumption at postoperative hour 24 was significantly fewer in group II. Conclusions: Intraarticular ropivacaine-morphine combination provides effective pain relief, longer analgesic duration, and less analgesic requirement when compared with intra-articular ropivacaineclonidine combination and saline after arthroscopic ACL reconstruction surgery.

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Preemptive intraarticular tramadol for pain control after arthroscopic knee surgery

Cited by 6 publications

References 0 publications

Preemptive analgesia with intra-articular pethidine reduces pain after arthroscopic knee surgery

Preemptive analgesia with intra-articular pethidine reduces pain after arthroscopic knee surgery

Tramadol as an adjunct to intra‐articular local anaesthetic infiltration in knee arthroscopy: a systematic review and meta‐analysis

Analysis of extra articular proximal third tibial fractures treated with interlocked intramedullary nailing

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