Comparison of tramadol/acetaminophen fixed-dose combination, tramadol, and acetaminophen in patients undergoing ambulatory arthroscopic meniscectomy

Acta Orthop Traumatol Turc. 2018 May;52(3):222-225. doi: 10.1016/j.aott.2018.02.011. Epub 2018 Mar 26.


Objectives: Preemptive analgesia is a technique in which analgesics are administered before a surgery to provide better postoperative pain relief with fewer side effects. In this study, we aimed to compare the preemptive efficacy of tramadol/acetaminophen fixed-dose combination, tramadol, and acetaminophen in patients undergoing ambulatory arthroscopic partial meniscectomy.

Methods: We evaluated the patient records of 75 patients who underwent ambulatory arthroscopic partial meniscectomy. We divided the patients into three groups consisting of 20 patients each to equalize the groups. Group A comprised patients who were administered 37.5 mg tramadol/325 mg acetaminophen fixed-dose combination, Group B comprised patients who were administered 50 mg tramadol, and Group C comprised patients who were administered 500 mg acetaminophen. Premedication was not used in any group.

Results: There were no significant differences between the groups in terms of age, sex, BMI, and duration of surgery and anesthesia. All patients in Group B and Group C and 17 patients in Group A required rescue analgesics in the first 6 h. Visual analog scale (VAS) was 4.75 ± 3.05 in Group B at time 0 and was 6.10 ± 1.86 in Group C in the first hour and was higher than the other groups with a statistically significance (p = 0.030 and 0.020, respectively). VAS at 24 h postoperatively was ≤3 (1.60 ± 1.63, 1.55 ± 1.84 and 1.70 ± 0.65 respectively in each group), and none of the patients in any group required rescue analgesics. No major side effects, except for slight nausea in one patient requiring no medication, were noted in any group.

Conclusion: The fixed-dose combination of tramadol/acetaminophen or tramadol alone is better than acetaminophen alone as a preemptive analgesic in patients undergoing ambulatory arthroscopic meniscectomy.

Level of evidence: Level III, therapeutic study.

Keywords: Acetaminophen; Arthroscopic meniscectomy; Preemptive analgesia; Tramadol.

Publication types

  • Comparative Study

MeSH terms

  • Acetaminophen* / administration & dosage
  • Acetaminophen* / pharmacokinetics
  • Adult
  • Analgesics / administration & dosage
  • Analgesics / pharmacokinetics
  • Arthroscopy* / adverse effects
  • Arthroscopy* / methods
  • Dose-Response Relationship, Drug
  • Drug Combinations
  • Drug Monitoring / methods
  • Drug Therapy, Combination / methods
  • Female
  • Humans
  • Male
  • Medical Records, Problem-Oriented / statistics & numerical data
  • Meniscectomy* / adverse effects
  • Meniscectomy* / methods
  • Middle Aged
  • Pain Measurement / methods
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / drug therapy*
  • Retrospective Studies
  • Tramadol* / administration & dosage
  • Tramadol* / pharmacokinetics
  • Turkey


  • Analgesics
  • Drug Combinations
  • Acetaminophen
  • Tramadol