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The use of a non-benzodiazepine hypnotic sleep-aid (Zolpidem) in patients undergoing ACL reconstruction: a randomized controlled clinical trial

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Previous studies have addressed post-operative pain management after ACL reconstruction by examining the use of intra-articular analgesia and/or modification of anesthesia techniques. To our knowledge, however, no previous studies have evaluated the effect of zolpidem on post-operative narcotic requirements, pain, and fatigue in patients undergoing outpatient arthroscopic ACL reconstruction. The purpose of this prospective, blinded, randomized, controlled clinical study was to evaluate the effect of zolpidem on post-operative narcotic requirements, pain, and fatigue in patients undergoing outpatient arthroscopic ACL reconstruction.

Methods

Twenty-nine patients undergoing arthroscopic ACL reconstruction were randomized to a treatment group or placebo group. Both groups received post-operative hydrocodone/acetaminophen bitartrate (Vicodin ES). Patients in the treatment group received a single dose of zolpidem for the first seven post-operative nights. Patients in the placebo group received a gelatin capsule similar in appearance to zolpidem. The amount of Vicodin used in each group, the amount of post-operative pain, and the amount of post-operative fatigue were analyzed.

Results

Following ACL reconstruction, a 28% reduction was seen in the total amount of narcotic consumed with zolpidem (P = 0.047) when compared to placebo. There were no significant differences in post-operative pain or fatigue levels between zolpidem and placebo.

Conclusion

Adding zolpidem to the post-operative medication regimen after arthroscopic ACL reconstruction helps to lower the amount of narcotic pain medication required for adequate analgesia.

Level of evidence

Randomized controlled clinical trial, Level I.

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Acknowledgments

The authors wish to acknowledge that this study was completed with the assistance of an educational grant from Smith and Nephew. This was used to defray the pharmacy costs, including the zolpidem and placebo pills, and the preparation of the pills.

Conflict of interest

The authors wish to report that there are no conflicts of interest for any of the authors, their immediate families, or any research foundation related to the subject of this study.

Ethical standards

This study was approved by our Institutional Review Board prior to initiation of the study. All persons involved in the study gave their informed consent prior to inclusion in the study.

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Alpert Brown Medical School/Rhode Island Hospital, 593 Eddy Street, Providence, RI, 02903, USA

    Marc Tompkins, Matthew Plante, Keith Monchik, Braden Fleming & Paul Fadale

Authors
  1. Marc Tompkins
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  2. Matthew Plante
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  3. Keith Monchik
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  4. Braden Fleming
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  5. Paul Fadale
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Corresponding author

Correspondence to Marc Tompkins.

Additional information

Clinical Relevance: This study demonstrates that zolpidem can be an A3 effective part of a multimodal post-operative treatment regimen for A4 pain relief following ACL reconstruction

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Tompkins, M., Plante, M., Monchik, K. et al. The use of a non-benzodiazepine hypnotic sleep-aid (Zolpidem) in patients undergoing ACL reconstruction: a randomized controlled clinical trial. Knee Surg Sports Traumatol Arthrosc 19, 787–791 (2011). https://doi.org/10.1007/s00167-010-1368-x

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  • DOI: https://doi.org/10.1007/s00167-010-1368-x

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