title: The comparison of intraarticular morphine-bupivacaine and tramadol-bupivacaine in postoperative analgesia after arthroscopic anterior cruciate ligament reconstruction.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  I.
authors: Department of Anesthesiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors: Habibollah
authors: H
authors: Hosseini
authors: Seyyed Mohammad Jalil
authors: SM
authors: Abrisham
authors: Hossein
authors: H
authors: Jomeh
authors: Mohammad
authors: M
authors: Kermani-Alghoraishi
authors: Rahil
authors: R
authors: Ghahramani
authors: Mohammad Reza
authors: MR
authors: Mozayan
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000777:Anesthetics / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage; D059549:Anterior Cruciate Ligament Reconstruction; D001182:Arthroscopy; D002045:Bupivacaine / Q000008:administration & dosage*; D004311:Double-Blind Method; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D009020:Morphine / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000188:drug therapy*; D014147:Tramadol / Q000008:administration & dosage*
chemical_list: D000701:Analgesics, Opioid; D000777:Anesthetics; D000779:Anesthetics, Local; D014147:Tramadol; D009020:Morphine; D002045:Bupivacaine