Comparing the Efficacy of Intra-Articular Application of Morphine and Tramadol on Postoperative Pain After Arthroscopic Knee Surgery

Background: Intra-articular analgesia is a pain reliever that is frequently administered following arthroscopic knee surgery.

Objectives: The purpose of this study was to compare the efficacy of intra-articular application\r\nof morphine and tramadol on postoperative pain after arthroscopic knee surgery

Patients and Methods: For this randomized double blinded clinical trial, 132 patients\r\nundergoing minor arthroscopic knee surgery were randomly assigned to receive either;\r\n5 mg morphine or 50 mg tramadol intra-articularly. Pain was evaluated by means of the\r\nverbal pain rating score (VRS) preoperatively (at rest and on movement of the knee joint)\r\nand postoperatively at 0, 1, 2, 3, 4, 6, 12 and 24 hours. Meanwhile, the time of the first analgesic\r\nrequest and need for supplemental analgesic were also recorded.

Results: There was no statistically significant difference in VRS scoring between the two\r\ngroups during the preoperative period either at rest or on knee movement. Meanwhile,\r\nVRS scores did not differ significantly between the morphine and tramadol treated\r\ngroups postoperatively, except for in the one-hour post-operative scores in which the\r\ntramadol-treated group experienced less pain (P < 0.007). Post-operative VRS scores at\r\n6, 12, and 24 hours were significantly decreased when compared with previous scores in\r\nboth morphine and tramadol prescribed subjects (P < 0.001), hence, both local analgesics\r\ncan significantly reduce pain after minor knee surgery.

Conclusions: We have found a postoperative analgesic effect of intra-articularly administered\r\nmorphine and tramadol following minor arthroscopic knee surgeries with a\r\nmaximum effect 6 hours post injection.