Sixty patients undergoing total knee replacement were randomized to different pain management strategies to determine if tramadol patient-controlled analgesia (PCA) in combination with metoclopramide is as effective in reducing pain when compared to morphine PCA. The study also aimed to determine if tramadol and metoclopramide yielded improved postoperative nausea and vomiting outcomes. The results from this study demonstrated comparable pain scores and similar outcomes when examining nausea and emesis, indicating that metoclopramide in combination with tramadol PCA may be an effective alternative to morphine PCA.