title: Intravenous Paracetamol Versus Patient-Controlled Analgesia With Morphine for the Pain Management Following Diagnostic Knee Arthroscopy in Trauma Patients: A Randomized Clinical Trial.
abstract: BACKGROUND
  Most patients undergoing outpatient surgeries have the unpleasant experience of high level pain after surgery. Compared with open surgeries, arthroscopic procedures are less painful; however, inadequate pain management could be associated with significant concerns. Opioids alone or in combination with local anesthetics are frequently used for diminishing postoperative pain using intravenous or epidural infusion pumps. Despite morphine various disadvantages, it is commonly used for controlling pain after surgery.
  
  
  OBJECTIVE
  The aim of this study was to compare intravenous paracetamol and patient-controlled analgesia (PCA) with morphine for the pain management following diagnostic knee arthroscopy in trauma patients.
  
  
  METHODS
  Sixty trauma patients who were scheduled to undergo knee arthroscopy were randomly divided into two groups. Patients immediately received intravenous infusion of 1 g paracetamol within 15 minutes after surgery and every 6 hours to 24 hours in the paracetamol group. The patient-controlled analgesia group received morphine through PCA infusion pump at 2 mL/h base rate and 1mL bolus every 15 minutes. Pain level, nausea and vomiting, and sedation were measured and recorded during entering the recovery, 15 and 30 minutes after entering the recovery, 2, 6, and 24 hours after starting morphine pump infusion in the morphine and paracetamol in the paracetamol groups.
  
  
  RESULTS
  There was no significant difference regarding the pain level at different times after entering the recovery between the two groups. No one from the paracetamol group developed drug complications. However, 22.3% in the PCA morphine suffered from postoperative nausea; there was a statistically significant difference regarding the sedation level, nausea, and vomiting at various times between the two groups.
  
  
  CONCLUSIONS
  Intravenous administration of paracetamol immediately after knee arthroscopy improved postoperative pain, decreased analgesic administration, maintained stable hemodynamic parameters, had no complications related to opiates, no nausea and vomiting, and increased patient satisfaction and comfort in comparison to PCA with morphine.
authors: Department of Pain Management, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors: Seyed Masoud
authors: SM
authors: Hashemi
authors: Department of Orthopedics, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors: Aliakbar
authors: A
authors: Esmaeelijah
authors: Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, IR Iran.
authors: Samad
authors: S
authors: Golzari
authors: Department of Orthopedics, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors: Sohrab
authors: S
authors: Keyhani
authors: Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors: Azita
authors: A
authors: Maserrat
authors: Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors: Gholamreza
authors: G
authors: Mohseni
authors: Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors: Seyed Hosein
authors: SH
authors: Ardehali
keywords: Acetaminophen; Analgesia; Arthroscopy; Morphine; Pain Management; Patient Safety; Patient-Controlled