title: Comparison of intra-articular bupivacaine-morphine with bupivacaine-tenoxicam combinations on post-operative analgesia in patients with arthroscopic meniscectomy: a prospective, randomised study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  level 1, therapeutic, randomised, multicentric study.
authors.affiliation: Maltepe University Faculty of Medicine Department of Orthopaedics and Traumatology, Marmara Egitim Koyu, 34857, Maltepe, Istanbul, Turkey. sesanel@hotmail.com.
authors.forename: Selim
authors.initials: S
authors.lastname: Sanel
authors.affiliation: Istanbul Medeniyet University Faculty of Medicine Department of Anesthesiology and Reanimation, Marmara Egitim Koyu, 34857, Maltepe, Istanbul, Turkey. arpazo@gmail.com.
authors.forename: Osman
authors.initials: O
authors.lastname: Arpaz
authors.affiliation: Istanbul Medeniyet University Goztepe Training and Research Hospital Department of Orthopaedics and Traumatology, Doktor Erkin Caddesi, 34722, Istanbul, Turkey. kunay69@yahoo.com.
authors.forename: Koray
authors.initials: K
authors.lastname: Unay
authors.affiliation: Istanbul Medeniyet University Goztepe Training and Research Hospital Department of Orthopaedics and Traumatology, Doktor Erkin Caddesi, 34722, Istanbul, Turkey. dr.ismailturkmen@gmail.com.
authors.forename: Ismail
authors.initials: I
authors.lastname: Turkmen
authors.affiliation: Istanbul Medeniyet University Faculty of Medicine Department of Anesthesiology and Reanimation, Marmara Egitim Koyu, 34857, Maltepe, Istanbul, Turkey. simseks@gmail.com.
authors.forename: Selcuk
authors.initials: S
authors.lastname: Simsek
authors.affiliation: Maltepe University Faculty of Medicine Department of Orthopaedics and Traumatology, Marmara Egitim Koyu, 34857, Maltepe, Istanbul, Turkey. eugutmen@gmail.com.
authors.forename: Ender
authors.initials: E
authors.lastname: Ugutmen
mesh_terms: D000328:Adult; D000698:Analgesia / Q000379:methods; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects; D019162:Anesthetics, Combined / Q000008:administration & dosage* / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects; D001182:Arthroscopy; D002045:Bupivacaine / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010894:Piroxicam / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000700:Analgesics; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D010894:Piroxicam; D009020:Morphine; D002045:Bupivacaine; C032801:tenoxicam
keywords: Analgesia; Bupivacaine; Intra-articular; Meniscectomy; Morphine; Tenoxicam