Selim Sanel1, Osman Arpaz2, Koray Unay3, Ismail Turkmen4, Selcuk Simsek5, Ender Ugutmen6. 1. Maltepe University Faculty of Medicine Department of Orthopaedics and Traumatology, Marmara Egitim Koyu, 34857, Maltepe, Istanbul, Turkey. sesanel@hotmail.com. 2. Istanbul Medeniyet University Faculty of Medicine Department of Anesthesiology and Reanimation, Marmara Egitim Koyu, 34857, Maltepe, Istanbul, Turkey. arpazo@gmail.com. 3. Istanbul Medeniyet University Goztepe Training and Research Hospital Department of Orthopaedics and Traumatology, Doktor Erkin Caddesi, 34722, Istanbul, Turkey. kunay69@yahoo.com. 4. Istanbul Medeniyet University Goztepe Training and Research Hospital Department of Orthopaedics and Traumatology, Doktor Erkin Caddesi, 34722, Istanbul, Turkey. dr.ismailturkmen@gmail.com. 5. Istanbul Medeniyet University Faculty of Medicine Department of Anesthesiology and Reanimation, Marmara Egitim Koyu, 34857, Maltepe, Istanbul, Turkey. simseks@gmail.com. 6. Maltepe University Faculty of Medicine Department of Orthopaedics and Traumatology, Marmara Egitim Koyu, 34857, Maltepe, Istanbul, Turkey. eugutmen@gmail.com.
Abstract
AIM: There are many alternatives for post-operative pain relief in patients who have had general anaesthesia. The aim of this study was to evaluate the efficacy of intra-articular bupivacaine + morphine and bupivacaine + tenoxicam applications in post-operative pain control in patients undergoing knee arthroscopy with general anaesthesia. METHOD: This was a prospective study. Standard anaesthesia procedures were applied to each patient, and the 240 patients chosen at random were then divided into two groups. Each group received a different combination of drugs for this double-blind study. The first group (group A: 120 patients) received 0.5% bupivacaine 100 mg + tenoxicam 20 mg (22 ml); the second group (group B) received 0.5% bupivacaine 100 mg + morphine 2 mg (22 ml); both groups received their drugs at the end of the intra-articular operation before tourniquet deflation. Before the operation, patients were asked about their post-operative pain at particular periods over the following 24 hours using the visual analogue scale (VAS) and the numeric rating scale (NRS). An additional analgaesic requirement and possible side effects were also recorded. RESULTS: Group A patients needed analgaesics sooner after operation than patients in group B. In Group B, VAS and NRS values were statistically higher compared with group A at the 12th hour. There were also fewer side effects seen in group A versus group B. CONCLUSION: Effective and reliable results were obtained in post-operative pain control in bupivacaine added to the morphine or tenoxicam groups following arthroscopic meniscectomy. In the tenoxicam group, patients reported less pain, fewer side effects and less need for analgesics at 12 hours after the operation. LEVEL OF EVIDENCE: level 1, therapeutic, randomised, multicentric study.
RCT Entities:
AIM: There are many alternatives for post-operative pain relief in patients who have had general anaesthesia. The aim of this study was to evaluate the efficacy of intra-articular bupivacaine + morphine and bupivacaine + tenoxicam applications in post-operative pain control in patients undergoing knee arthroscopy with general anaesthesia. METHOD: This was a prospective study. Standard anaesthesia procedures were applied to each patient, and the 240 patients chosen at random were then divided into two groups. Each group received a different combination of drugs for this double-blind study. The first group (group A: 120 patients) received 0.5% bupivacaine 100 mg + tenoxicam 20 mg (22 ml); the second group (group B) received 0.5% bupivacaine 100 mg + morphine 2 mg (22 ml); both groups received their drugs at the end of the intra-articular operation before tourniquet deflation. Before the operation, patients were asked about their post-operative pain at particular periods over the following 24 hours using the visual analogue scale (VAS) and the numeric rating scale (NRS). An additional analgaesic requirement and possible side effects were also recorded. RESULTS: Group A patients needed analgaesics sooner after operation than patients in group B. In Group B, VAS and NRS values were statistically higher compared with group A at the 12th hour. There were also fewer side effects seen in group A versus group B. CONCLUSION: Effective and reliable results were obtained in post-operative pain control in bupivacaine added to the morphine or tenoxicam groups following arthroscopic meniscectomy. In the tenoxicam group, patients reported less pain, fewer side effects and less need for analgesics at 12 hours after the operation. LEVEL OF EVIDENCE: level 1, therapeutic, randomised, multicentric study.