Intra-articular Tramadol Improves Outcome of Knee Arthroscopy under Local Anesthesia
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This study was designed to evaluate outcomes of artliroscopic surgery performed under intraarticular (Ml local anesthetic (LA) Patients & Methods: This study included 60 patients (48 men and 12 females) with a mean age of 36.3H0.5 years. EMLA cream ivas applied after exposure of the knee to heat moist for 10 minutes, then patients received IA injection of 1% xylocaine (Group A) or xylocaine plus 100 mg tramadol in group B, then injection sites were massaged. Patients were asked to evaluate injection pain using 10point visual analogue scale (VAS), procedure pain using 4-points verbal analogue scale (VrAS) and satisfaction score (SS) with pain control during surgery. Duration of postoperative analgesia and consumption of analgesics were recorded. Results: Injection pain was highly ameliorated after EMLA cream application and 17 patients (28.3%) reported no injection pain, 13 patients (21.7%) had VAS score 1, 22 patients (36.7%) had VAS score 2 and 8 patients (13.3%) had VAS score 3. In 19 patients (31.7%) no pain was reported till end of procedure, 34 patients (56.7%) had mild pain and in group A, 6 (10%) had moderate and one patient (1.6%) had severe pain with a significant difference (X2=5.16, P<0.05) in favor of group B. All patients in group B and 18 patients (60%) in group A were satisfied with the applied anesthetic technique with a significant QG=U,5, P<0.05) difference between both groups. All patients in group B and 20 patients in group A had no objection to undergo similar procedures using the same anesthetic. Postoperative analgesia was significantly longer in group B and 10 patients did not request analgesia. Conclusion: It could be concluded that the intraarticular use of combination of xylocaine and tramadol after local application of EMLA cream provided effective intra and postoperative analgesia, approach maximal patients' satisfaction and permitted arthroscopy as outpatient procedure.