Intra-articular analgesia with ketamine and tramadol; the effect of the type of surgery

摘要: Arthroscopies are most commonly performed on day case basis, but postoperative pain remains a problem as more complicated procedures are performed. This study was carried out on 60 adult ASA I-II patients undergoing arthroscopic procedures. Patients were assigned into 2 equal groups; group I underwent low inflammatory surgeries, whereas group II had high inflammatory surgeries. Both groups were further subdivided randomly into 3 equal subgroups. Subgroup K received 0.5 mg kg-1 ketamine intra-articularly, subgroup T received 100 mg tramadol intra-articularly and subgroup S received placebo. The following parameters were recorded; vital signs, first time to ask for analgesia, total rescue iv pethidine given and VAS scores hourly for the 1st 6 hours, then 3-hourly till the end of the first postoperative day.Results: Group I showed significantly delayed onset of pain (p=. 009), lower pethidine consumption (p=. 036) and lower VAS scores at 1, 4, 5, 6, 9, 12, 15, 18, 21, and 24 hours. On the other hand, on comparing K, T and S subgroups, both K and T subgroups showed a significant delay in asking for analgesic (p=. 001), significantly lower pethidine consumption (p=. 001) and significantly lower VAS scores at 1, 2, 3, 6, 12, 15, and 24 hours as compared to S subgroups. On comparing K and T subgroups, there was no significant difference among them except in the first 2 hours where K subgroups had significantly lower VAS in the first hour (p=. 018), while T-subgroups showed significantly lower VAS in the second hour (p=. 004). conclusion: Both ketamine and tramadol proved to be useful and safe analgesic agents when applied intra …