title: Peroral tramadol premedication increases postoperative nausea and delays home-readiness in day-case knee arthroscopy patients.
abstract: OBJECTIVE
  To evaluate the effect of preoperative oral tramadol on postoperative pain and its effect on the patient's home-readiness after diagnostic day-case knee arthroscopy performed under spinal anaesthesia.
  
  
  METHODS
  We studied 156 outpatients in a prospective, randomized, double-blind fashion to examine the postoperative analgesic effect of preoperative oral slow-release tramadol. Postoperative pain was measured using a 100-mm visual analogue scale (VAS). Postoperative nausea and vomiting (PONV) and the patients home-readiness were assessed.
  
  
  RESULTS
  There were no statistically significant differences in the postoperative VAS scores between the tramadol and placebo groups, nor was there any significant difference in the need for postoperative pain medication. Patients in the tramadol group had higher incidence of PONV and they were discharged from hospital later than those given placebo although the tramadol patients required less intravenous midazolam for sedation.
  
  
  CONCLUSIONS
  Preoperatively given slow-release tramadol is ineffective for reduction of postoperative pain after day-case arthroscopy of the knee. Additionally, preoperative tramadol is associated with higher incidence of PONV and it seems to cause delay in the patient's home-readiness.
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland.
authors.forename: K
authors.initials: K
authors.lastname: Liukkonen
authors.forename: U
authors.initials: U
authors.lastname: Santanen
authors.forename: P
authors.initials: P
authors.lastname: Pere
authors.forename: O
authors.initials: O
authors.lastname: Erkola
authors.forename: P
authors.initials: P
authors.lastname: Rautoma
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D001182:Arthroscopy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced*; D011292:Premedication; D014147:Tramadol / Q000627:therapeutic use*; D017211:Treatment Failure
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol