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The comparison of intraarticular morphine–bupivacaine and tramadol–bupivacaine in postoperative analgesia after arthroscopic anterior cruciate ligament reconstruction

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

Abstract

Purpose

To compare intraarticular morphine–bupivacaine and tramadol–bupivacaine as postoperative analgesics in patients undergoing arthroscopic anterior cruciate ligament (ACL) reconstruction.

Methods

A randomized, double blind, controlled trial study of 60 ASA I–II patients undergoing arthroscopic ACL reconstruction was performed under general anesthesia. Patients were randomly allocated into three groups. The MB group (n = 20) received 10 mg morphine and 0.5% bupivacaine; the TB group (n = 20) received 100 mg tramadol and 0.5% bupivacaine; and the control group (n = 20) received isotonic saline intraarticularly in a total volume of 20 ml after the operation. Postoperative pain was assessed with visual analogue scale (VAS) at 0, 30, 60, 90 min and 2, 4, 6, 12, 24 h being at rest. Analgesic duration as defined was the time of first request for analgesics, the first 24 h analgesic consumption, time to unassisted ambulation, discharge time and incidence of side effects were also evaluated.

Results

The VAS scores at 30, 60, 90 min and 2, 4, 12, 24 h were significantly less in the MB and TB groups in comparison with the control group (P < 0.05); VAS scores also decreased significantly in the MB group compared to the TB group at 2, 4 and 24 h (P < 0.05). Analgesic duration was longer and analgesic consumption was substantially less in the MB group (P < 0.05). Moreover, unassisted ambulation time and discharge time were significantly shorter in the MB group than the TB and control groups (P < 0.05). Side effects were similar among the groups.

Conclusions

Intraarticular morphine–bupivacaine provides effective pain relief, longer analgesic duration, less analgesic requirement, shorter unassisted ambulation and discharge time were compared with intraarticular tramadol–bupivacaine after ACL reconstruction arthroscopy.

Level of evidence

I.

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Acknowledgments

The authors gratefully acknowledge Miss Ladan Ghahramani (Allameh Tabataba’i University, Tahran, Iran) and Mr. Majid Zareian (Shahid Sadoughi Hospital, Yazd, Iran) for their cooperation and editing this paper.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Anesthesiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

    Habibollah Hosseini & Hossein Jomeh

  2. Department of Orthopedics, Shahid Sadoughi University of Medical Sciences, Shahid Sadoughi Hospital, Ebne Sina Blvd, Shahid Ghandi Blvd, Safaeeie, Yazd, Iran

    Seyyed Mohammad Jalil Abrisham

  3. Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

    Mohammad Kermani-Alghoraishi & Rahil Ghahramani

  4. Department of English Language, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

    Mohammad Reza Mozayan

Authors
  1. Habibollah Hosseini
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  2. Seyyed Mohammad Jalil Abrisham
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  3. Hossein Jomeh
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Correspondence to Seyyed Mohammad Jalil Abrisham.

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Hosseini, H., Abrisham, S.M.J., Jomeh, H. et al. The comparison of intraarticular morphine–bupivacaine and tramadol–bupivacaine in postoperative analgesia after arthroscopic anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 20, 1839–1844 (2012). https://doi.org/10.1007/s00167-011-1791-7

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  • DOI: https://doi.org/10.1007/s00167-011-1791-7

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