ABSTRACT
Sixty-eight patients undergoing outpatient knee arthroscopy for treatment of meniscal
tears or loose bodies were divided into three treatment groups (zolpidem [24 patients],
control [24 patients], and placebo [20 patients]). All groups received postoperative
hydrocodone and ibuprofen. Patients in the zolpidem group received a single dose of
zolpidem tartrate for the first seven postoperative nights. Patients in the placebo
group received a gelatin capsule similar in appearance to zolpidem and patients in
the control group received only hydrocodone and ibuprofen.
Patients in the control group demonstrated significantly worse mean daily postoperative
pain and more daily postoperative fatigue on visual analog scales when compared with
the zolpidem group (P = .03 and P = .04, respectively). Patients in the placebo group had worse daily postoperative
pain and more daily postoperative fatigue when compared to the zolpidem group, although
these differences did not reach statistical significance (P = .15, power = 0.6; and P = .27, power = 0.48, respectively). Patients in the control group consumed significantly
higher quantities of hydrocodone/acetaminophen postoperatively (P = .04) than patients in the zolpidem group. Finally, patients in the placebo group
consumed higher quantities of hydrocodone/acetaminophen than the zolpidem group although
the difference did not reach statistical significance (P = .4; power = 0.15). Power was calculated for each insignificant relationship based
on observed effect and sample sizes and variances.
This study demonstrates that sleep and fatigue may be an important factor in the effective
pain management following knee arthroscopy. Future postoperative treatment regimens
should address sleep and fatigue to maximize analgesic effects in these patients.
