Author/Authors :
Arti, Hamidreza Associate Professor, Department of Orthopedic Surgery and Trauma Research Center - School of Medicine, Ahvaz Jundishapur University of Medical Sciences , Mehdinasab, Abdoulhossein Associate Professor, Department of Orthopedic Surgery and Trauma Research Center - School of Medicine, Ahvaz Jundishapur University of Medical Sciences
Abstract :
BACKGROUND: Pain after knee surgery, if not relieved, it would lead to a more severe and prolonged pain that can delay
the patients recovery and rehabilitation. The effect of pain relief by some drugs after intra-articular injection has been
shown. This study compared the effect of intra-articular injection of opioids (morphine, pethidine, methadone, and tramadol)
on postoperative relieving pain after arthroscopic anterior cruciate ligament (ACL) reconstruction.
METHODS: 150 candidate patients for knee arthroscopic ACL reconstruction were randomly enrolled into five groups.
At the end of the procedure, all patients in each group received a joint injection solution including 9.5 millimeters bupivacaine
with 1:200,000 epinephrine. The remaining 0.5 milliliters of syringe capacity was filled with one of the five
solutions listed below: methadone group I: 5 mg methadone, morphine group II: 5 mg morphine, pethidine group III:
37.5 mg pethidine, tramadol group IV: 100 mg Tramadol, and control group V: 0.5 ml normal saline. Afterwards, any
drug further administered to the patients based on need was recorded, and the morphine equivalent for all drugs was
calculated. Patients need to narcotic drugs during the first twelve hours of hospitalization and pain scores were recorded.
After data gathering, they were analyzed by SPSS 16 software with chi-Square, Kruskal-Wallis and ANOVA
statistical tests.
RESULTS: The highest and the lowest significant pain intensity were seen in placebo and morphine groups, respectively,
in the first, second and third 4 hours after surgery. There were significant differences among the groups for need to analgesics.
In other words, placebo group needed the highest dosage of analgesics and morphine and methadone groups
needed the lowest dosage of analgesics. Morphine and methadone groups had maximum and minimum response to
pain, respectively, in the first, second and third 4 hours after surgery.
Keywords :
Knee Arthroscopic , Morphine , Pethidine , Methadone , Tramadol , Intra-Articular Injection
