Tramadol or fentanyl analgesia for ambulatory knee arthroscopy

Abstract

In a double-blind, randomized, controlled study, 61 patients who received a standardized anaesthetic for day case arthroscopic knee surgery were studied. Group T (n = 31) received tramadol 1.5 mg kg-1, and group F (n = 30) received fentanyl 1.5 micrograms kg-1 at the induction of anaesthesia. All patients also received 20 mL of intra-articular bupivacaine 0.5% at the end of surgery. Assessments were made of pain at rest and on movement, analgesic requirements and side-effects at hourly intervals up to 6 h and by means of a postal questionnaire at 24 h and 48 h post-operatively. Group F had higher pain scores than group T at 4 h only [VAS 3.3 (1.6-5.5) vs. 2.4 (1-4), P = 0.039, respectively; median (interquartile range)]. There were no other significant differences between the groups in terms of pain scores, supplemental analgesic requirements or incidence of side-effects. We conclude that tramadol offers little benefit clinically compared with fentanyl when used at induction of anaesthesia for day case arthroscopic knee surgery. Further studies are indicated in patients with more severe pain to determine the role of tramadol in post-operative analgesia.

Peroral Tramadol Premedication Increases Postoperative Nausea and Delays Home-Readiness in Day-Case Knee Arthroscopy Patients

“…In both groups the visual analogue scale (VAS) levels were low during the 48-hour postoperative study period. Tramadol was similar to fentanyl in postoperative pain management and incidence of side-effects (10).…”

Tramadol—Present and Future

“…After arthroscopic anterior cruciate ligament reconstruction, IM lornoxicam provided a useful alternative to IM tramadol for postoperative analgesia 113 . Tramadol 1.5 mg/kg IV offers little benefit clinically compared with fentanyl 1.5 µg/kg IV when used at the induction of anaesthesia for day-case arthroscopic surgery 114 .…”

Effects of Viscoseal, a synovial fluid substitute, on recovery after arthroscopic partial meniscectomy and joint lavage

“…While the long-term benefits of arthroscopic partial meniscectomy have been established, the immediate post-operative period up to about 4 weeks after the intervention is characterised by symptoms including pain, impaired joint function and joint effusion [1]. Postoperative pain is usually greater in the first 24 h after surgery [1].…”

“…Postoperative pain is usually greater in the first 24 h after surgery [1]. This pain could be due to several events including soft tissue injury during surgery and due to the liberation of free radicals, cytokines and other hyperalgesic substances that form an integral part of the inflammatory process.…”