Comparative study between intravenous ibuprofen, intravenous tramadol alone and in combination after arthroscopic reconstruction surgery

Abstract

Background Ambulatory anesthesia is becoming a major part of an anesthetist’s workload. Inadequate postoperative analgesia can delay discharge and impair a patient’s return to full function. Aim The aim of this study was to evaluate the analgesic efficacy of intravenous ibuprofen as a newly intravenous analgesic and tramadol when used alone and when combined. Methods This blind randomized study included 75 patients according to American Society of Anesthesiologists physical status I and II, aged between 19 and 46 years, and scheduled for arthroscopic reconstruction surgery. Patients were randomly allocated into three equal groups: group I received ibuprofen 800 mg intravenously, group II received tramadol 100 mg intravenously, and group III received a combination of both drugs ibuprofen 400 mg and tramadol 70 mg intravenously after induction. In all patients, anesthesia was induced with propofol (2–3 mg/kg), fentanyl (2 μg/kg), and a single dose of cisatracurium 0.15 mg/kg. Pain during rest and mobility was assessed in the immediate postoperative period, 2, 4, 6, and 8 h successively using the visual analogue scale (VAS), and opioid consumption was recorded. Results Group III showed significantly less consumption of morphine doses in comparison with either group I or group II. Although there was no statistically significant difference in VAS during rest among all groups, group III still had the least VAS scores during knee movement that was significant in comparison with group I or group II. Also, group I was statistically significant higher than group II. Eight hours postoperatively, there was significantly greater patient satisfaction with the postoperative pain management in group III in comparison with group I and group II. Conclusion A combination of intravenous ibuprofen and tramadol has been shown to provide better analgesia and higher patient satisfaction than each drug used separately. The combination of both drugs decreased the doses of each, which helped to avoid adverse effects.