scholarly journals Intra-articular Magnesium to Alleviate Postoperative Pain After Arthroscopic Knee Surgery: A Meta-analysis of Randomized Controlled Trials

2021 ◽  
Author(s):  
Lijun Shi ◽  
Haiyun Zhu ◽  
Jinhui Ma ◽  
Li-Li Shi ◽  
Fuqiang Gao ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Randomized Controlled Trials ◽  
Pain Intensity ◽  
Opioid Consumption ◽  
Knee Surgery ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Arthroscopic Knee Surgery ◽  
Randomized Controlled ◽  
Arthroscopic Knee

Abstract Objective: We aimed to evaluate the safety and efficacy of intra-articular (IA) magnesium (Mg) for postoperative pain relief after arthroscopic knee surgery. Methods. We searched PubMed, Embase, Medline, Cochrane library, and Web of Science to identify randomized controlled trials that compared postoperative pain outcomes with or without IA Mg after knee arthroscopy. The primary outcomes were pain intensity at rest and with movement at different postoperative time points and cumulative opioid consumption within 24 hours after surgery. Secondary outcomes included the time to first analgesic request and side effects. Results. In total, 11 studies involving 677 participants met the eligibility criteria. Pain scores at rest and with movement 2, 4, 12, and 24 h after surgery were significantly lower, doses of supplementary opioid consumption were smaller, and the time to first analgesic requirement was longer in the IA Mg group compared with the control group. No significant difference was detected regarding adverse reactions between the groups. Conclusions. Intra-articular magnesium is an effective and safe coadjuvant treatment for relieving postoperative pain intensity after arthroscopic knee surgery.Protocol registration at Prospero: CRD42020156403.

scholarly journals Intra-articular magnesium to alleviate postoperative pain after arthroscopic knee surgery: a meta-analysis of randomized controlled trials

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lijun Shi ◽  
Haiyun Zhu ◽  
Jinhui Ma ◽  
Li-Li Shi ◽  
Fuqiang Gao ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Randomized Controlled Trials ◽  
Pain Intensity ◽  
Opioid Consumption ◽  
Knee Surgery ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Arthroscopic Knee Surgery ◽  
Randomized Controlled ◽  
Arthroscopic Knee

Abstract Objective We aimed to evaluate the safety and efficacy of intra-articular (IA) magnesium (Mg) for postoperative pain relief after arthroscopic knee surgery. Methods We searched PubMed, Embase, Medline, Cochrane library, and Web of Science to identify randomized controlled trials that compared postoperative pain outcomes with or without IA Mg after knee arthroscopy. The primary outcomes were pain intensity at rest and with movement at different postoperative time points and cumulative opioid consumption within 24 h after surgery. Secondary outcomes included the time to first analgesic request and side effects. Results In total, 11 studies involving 677 participants met the eligibility criteria. Pain scores at rest and with movement 2, 4, 12, and 24 h after surgery were significantly lower, doses of supplementary opioid consumption were smaller, and the time to first analgesic requirement was longer in the IA Mg group compared with the control group. No significant difference was detected regarding adverse reactions between the groups. Conclusions Intra-articular magnesium is an effective and safe coadjuvant treatment for relieving postoperative pain intensity after arthroscopic knee surgery. Protocol registration at PROSPERO: CRD42020156403.

scholarly journals Intra-articular Magnesium to Alleviate Postoperative Pain After Arthroscopic Knee Surgery: A Meta-analysis of Randomized Controlled Trials

2020 ◽  
Author(s):  
Lijun Shi ◽  
Haiyun Zhu ◽  
Jinhui Ma ◽  
Li-Li Shi ◽  
Fuqiang Gao ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Randomized Controlled Trials ◽  
Pain Intensity ◽  
Adverse Reactions ◽  
Opioid Consumption ◽  
Knee Surgery ◽  
Controlled Trials ◽  
Arthroscopic Knee Surgery ◽  
Randomized Controlled ◽  
Arthroscopic Knee

Abstract Objective: We evaluated the safety and efficacy of intra-articular (IA) magnesium (Mg) for postoperative pain relief after arthroscopic knee surgery. Methods. We searched PubMed, Embase, Medline, Cochrane library, and Web of Science to identify randomized controlled trials that compared postoperative pain outcomes with or without IA Mg after knee arthroscopy. The primary outcomes were pain intensity at rest and with movement at different postoperative time points and cumulative opioid consumption within 24 hours after surgery. Secondary outcomes included the time to first analgesic request and side effects. Results. In total, 11 randomized controlled trials involving 677 subjects met the eligibility criteria. Pain scores at rest and with movement 2, 4, 12, and 24 h after surgery were significantly lower, doses of supplementary opioid consumption were smaller, and the time to first analgesic requirement was longer in the IA Mg group compared with the control group. No significant difference was detected regarding adverse reactions between the groups. Conclusions. Administering IA Mg following arthroscopic knee surgery is effective for relieving postoperative pain intensity, reducing opioid consumption, and prolonging the time before analgesics are needed without increasing adverse reactions. Protocol registration at Prospero: CRD42020156403.

scholarly journals Analgesic Effect of Dexamethasone after Arthroscopic Knee Surgery: A Randomized Controlled Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Jairo Moyano ◽  
Maria García ◽  
Maria Caicedo
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Knee Surgery ◽  
Controlled Study ◽  
Opioid Use ◽  
Arthroscopic Knee Surgery ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Intraoperative Period ◽  
Arthroscopic Knee

Background.Dexamethasone is sometimes used as a coanalgesic because of its anti-inflammatory properties.Objective. To evaluate opioid use, postoperative pain intensity, and side effects after a single dose of dexamethasone in patients undergoing arthroscopic knee surgery.Methods. In this randomized controlled study patients were randomized to receive either 10 mg of intravenous dexamethasone (DM group) or 0.9% normal saline (NS group) during the intraoperative period. Primary outcomes were pain intensity and total morphine and codeine use after surgery.Results. Seventy-eight patients were included in the study. The DM group showed statistically significant higher pain intensity at the fourth postoperative hour (DM: 3.96/10, standard deviation [SD] 0.54; NS: 2.46/10, SD 0.45;p=0.036). No statistically significant difference in total opioid use (morphine plus codeine) was identified with 15.9 (SD 1.97) codeine tablets used in DM group and 20 (SD 2.14) in NS group (p=0.25).Discussion. Pain intensity tended to decrease in both groups suggesting morphine as the main source of analgesia.Conclusions. Intravenous dexamethasone during the intraoperative period has no clinical impact on postoperative pain intensity during the first 48 h after arthroscopic knee surgery. This trial is registered withR000020892.

scholarly journals The Effect of Intraoperative Methadone Compared to Morphine on Postsurgical Pain: A Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Mark C. Kendall ◽  
Lucas J. Alves ◽  
Kristi Pence ◽  
Taif Mukhdomi ◽  
Daniel Croxford ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Randomized Controlled Trials ◽  
Surgical Procedures ◽  
Meta Analysis ◽  
Analgesic Efficacy ◽  
Opioid Consumption ◽  
Cochrane Library ◽  
Postanesthesia Care Unit ◽  
Controlled Trials ◽  
Randomized Controlled

Background and Objectives. Methadone is commonly used in chronic pain, but it is not frequently used as an intraoperative analgesic. Several randomized studies have compared intraoperative methadone to morphine regarding postsurgical analgesia, but they have generated conflicting results. The aim of this investigation was to compare the analgesic efficacy of intraoperative methadone to morphine in patients undergoing surgical procedures. Methods. We performed a quantitative systematic review of randomized controlled trials in PubMed, Embase, Cochrane Library, and Google Scholar electronic databases. Meta-analysis was performed using the random effects model, weighted mean differences (WMD), standard deviation, 95% confidence intervals, and sample size. Methodological quality was evaluated using Cochrane Collaboration’s tool. Results. Seven randomized controlled trials evaluating 337 patients across different surgical procedures were included. The aggregated effect of intraoperative methadone on postoperative opioid consumption did not reveal a significant effect, WMD (95% CI) of −0.51 (−1.79 to 0.76), (P=0.43) IV morphine equivalents. In contrast, the effect of methadone on postoperative pain demonstrated a significant effect in the postanesthesia care unit, WMD (95% CI) of −1.11 (−1.88 to −0.33), P=0.005, and at 24 hours, WMD (95% CI) of −1.35 (−2.03 to −0.67), P<0.001. Conclusions. The use of intraoperative methadone reduces postoperative pain when compared to morphine. In addition, the beneficial effect of methadone on postoperative pain is not attributable to an increase in postsurgical opioid consumption. Our results suggest that intraoperative methadone may be a viable strategy to reduce acute pain in surgical patients.

scholarly journals Thoracolumbar interfascial plane block for postoperative analgesia in spine surgery: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251980
Author(s):  
Yu Ye ◽  
Yaodan Bi ◽  
Jun Ma ◽  
Bin Liu
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Spine Surgery ◽  
Analgesic Efficacy ◽  
Opioid Consumption ◽  
Controlled Trials ◽  
Wound Infiltration ◽  
Rescue Analgesia ◽  
Randomized Controlled ◽  
Analgesia Requirement

Introduction Thoracolumbar interfascial plane (TLIP) block has been discussed widely in spine surgery. The aim of our study is to evaluate analgesic efficacy and safety of TLIP block in spine surgery. Method We performed a quantitative systematic review. Randomized controlled trials that compared TLIP block to non-block care or wound infiltration for patients undergoing spine surgery and took the pain or morphine consumption as a primary or secondary outcome were included. The primary outcome was cumulative opioid consumption during 0-24-hour. Secondary outcomes included postoperative pain intensity, rescue analgesia requirement, and adverse events. Result 9 randomized controlled trials with 539 patients were included for analysis. Compared with non-block care, TLIP block was effective to decrease the opioid consumption (WMD -16.00; 95%CI -19.19, -12.81; p<0.001; I2 = 71.6%) for the first 24 hours after the surgery. TLIP block significantly reduced postoperative pain intensity at rest or movement at various time points compared with non-block care, and reduced rescue analgesia requirement ((RR 0.47; 95%CI 0.30, 0.74; p = 0.001; I2 = 0.0%) and postoperative nausea and vomiting (RR 0.58; 95%CI 0.39, 0.86; p = 0.006; I2 = 25.1%). Besides, TLIP block is superior to wound infiltration in terms of opioid consumption (WMD -17.23, 95%CI -21.62, -12.86; p<0.001; I2 = 63.8%), and the postoperative pain intensity at rest was comparable between TLIP block and wound infiltration. Conclusion TLIP block improved analgesic efficacy in spine surgery compared with non-block care. Furthermore, current literature supported the TLIP block was superior to wound infiltration in terms of opioid consumption.

scholarly journals Usefulness of surgical pleth index-guided analgesia during general anesthesia: a systematic review and meta-analysis of randomized controlled trials

2018 ◽  
Vol 46 (11) ◽  
pp. 4386-4398 ◽  
Author(s):  
Young Ju Won ◽  
Byung Gun Lim ◽  
Young Sung Kim ◽  
Mido Lee ◽  
Heezoo Kim
Keyword(s):  
Postoperative Pain ◽  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Opioid Consumption ◽  
Controlled Trials ◽  
Intergroup Difference ◽  
Randomized Controlled ◽  
Pain Scores ◽  
Extubation Time

Objective Previous studies comparing surgical pleth index (SPI)-guided and conventional analgesia have shown differing results. Therefore, we compared the intraoperative opioid requirement, extubation time, postoperative pain scores, and perioperative adverse events between these two modalities. Methods A comprehensive literature search was conducted to identify randomized controlled trials comparing the intraoperative opioid requirement and other outcomes between the two modalities. The mean difference (MD) or the pooled risk ratio and corresponding 95% confidence interval (CI) were used for analysis. A heterogeneity (I2) assessment was performed. Results Six randomized controlled trials comparing 463 patients were included. Intraoperative opioid consumption was significantly lower in the SPI-guided than conventional analgesia group (standardized MD, −0.41; 95% CI, −0.70 to −0.11; I2 = 53%). No significant intergroup difference was observed in the pain score on the first postoperative day or the incidence of perioperative adverse events. The extubation time was considerably shorter in the SPI-guided than conventional analgesia group (MD, −1.91; 95% CI, −3.33 to −0.49; I2 = 67%). Conclusions Compared with conventional analgesia, SPI-guided analgesia can reduce intraoperative opioid consumption and facilitate extubation. Moreover, no intergroup difference was observed in the degree of postoperative pain or incidence of perioperative adverse events.

Pectoral nerve blocks and postoperative pain outcomes after mastectomy: a meta-analysis of randomized controlled trials

2019 ◽  
Vol 44 (10) ◽  
pp. 923-928 ◽  
Author(s):  
Danielle Lovett-Carter ◽  
Mark C Kendall ◽  
Zachary L McCormick ◽  
Edward I Suh ◽  
Alexander D Cohen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Postoperative Pain ◽  
Randomized Controlled Trials ◽  
Postoperative Analgesia ◽  
Meta Analysis ◽  
Opioid Consumption ◽  
Controlled Trials ◽  
Nerve Blocks ◽  
Randomized Controlled ◽  
Pectoral Nerve

Background and objectivesSeveral studies have evaluated the effect of pectoral nerve blocks to improve postoperative analgesia following breast cancer surgery resulting in contradictory findings. The aim of this study was to examine the effect of Pecs blocks on postoperative analgesia in women following mastectomies.MethodsWe performed a quantitative systematic review in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Articles of randomized controlled trials that compared Pecs block (types I and II) to a control group in patients undergoing mastectomy were included. The primary outcome was total opioid consumption 24 hours after surgery. Secondary outcomes included pain scores and side effects. Meta-analysis was performed using the random effect model.Results7 randomized controlled trials with 458 patients were included in the analysis. The effect of pectoral nerve blocks on postoperative opioid consumption compared with control revealed a significant effect, weighted mean difference (WMD) (95% CI) of -−4.99 (−7.90 to −2.08) mg intravenous morphine equivalents (p=0.001). In addition, postoperative pain compared with control was reduced at 6 hours after surgery: WMD (95% CI) of −0.72 (−1.37 to −0.07), p=0.03, and at 24 hours after surgery: WMD (95% CI) of −0.91 (−1.81 to −0.02), p=0.04.DiscussionThis quantitative analysis of randomized controlled trials demonstrates that the Pecs block is effective for reducing postoperative opioid consumption and pain in patients undergoing mastectomy. The Pecs block should be considered as an effective strategy to improve analgesic outcomes in patients undergoing mastectomies for breast cancer treatment.

scholarly journals The efficacy of intra-articular fentanyl supplementation for knee arthroscopy: A meta-analysis of randomized controlled studies

2020 ◽  
Vol 28 (1) ◽  
pp. 230949901990027 ◽  
Author(s):  
Jian-Zuo Lu ◽  
Jia-Xing Fu ◽  
Da-feng Wang ◽  
Zhong-Liang Su ◽  
Yuan-Bo Zheng
Keyword(s):  
Pain Control ◽  
Knee Arthroscopy ◽  
Meta Analysis ◽  
Knee Surgery ◽  
Cochrane Library ◽  
Arthroscopic Knee Surgery ◽  
Substantial Impact ◽  
Randomized Controlled ◽  
Pain Scores ◽  
Arthroscopic Knee

Introduction: The efficacy of intra-articular fentanyl supplementation for pain control after knee arthroscopy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of intra-articular fentanyl supplementation for pain intensity after arthroscopic knee surgery. Methods: We searched PubMed, EMbase, Web of Science, EBSCO, and Cochrane Library databases through May 2019 for randomized controlled trials (RCTs) assessing the efficacy and safety of intra-articular fentanyl supplementation for arthroscopic knee surgery. This meta-analysis is performed using the random-effects model. Results: Four RCTs are included in the meta-analysis. Overall, compared with control group after knee arthroscopy, intra-articular fentanyl supplementation is associated with reduced pain scores at 1 h (standard mean difference (Std MD) = −3.50; 95% confidence interval (CI) = −5.68 to −1.32; p = 0.002), 2 h (Std MD = −4.73; 95% CI = −8.75 to −0.71; p = 0.02), and 8 h (Std MD = −5.02; 95% CI = −9.73 to −0.30; p = 0.04) but shows no substantial impact on pain scores at 4 h (Std MD = −3.94; 95% CI = −7.93 to 0.05; p = 0.05) or the supplementary analgesia (risk ratio = 0.56; 95% CI = 0.09–3.59; p = 0.54). Conclusions: Intra-articular fentanyl supplementation does benefit in pain control after knee arthroscopy.

scholarly journals The efficacy of spinal anaesthesia with fentanyl supplementation for arthroscopic knee surgery: A meta-analysis of randomized controlled studies

2020 ◽  
Vol 28 (2) ◽  
pp. 230949901989036
Author(s):  
Jianfeng Chen ◽  
Chao Yan ◽  
Chaosong Luo ◽  
Guizhen Li ◽  
Zong Yang
Keyword(s):  
Spinal Anaesthesia ◽  
Knee Arthroscopy ◽  
Meta Analysis ◽  
Onset Time ◽  
Knee Surgery ◽  
Cochrane Library ◽  
Control Group ◽  
Arthroscopic Knee Surgery ◽  
Randomized Controlled ◽  
Arthroscopic Knee

Introduction: The efficacy of spinal anaesthesia with fentanyl supplementation for arthroscopic knee surgery remains controversial. We conducted a systematic review and meta-analysis to explore the influence of fentanyl supplementation for arthroscopic knee surgery. Methods: We searched PubMed, Embase, Web of Science, EBSCO and Cochrane Library databases through May 2019 for randomized controlled trials (RCTs) assessing the efficacy and safety of fentanyl supplementation for arthroscopic knee surgery. This meta-analysis is performed using the random-effects model. Results: Five RCTs are included in the meta-analysis. Overall, compared with the control group for knee arthroscopy, fentanyl supplementation is associated with decreased time for sensory block regression to S1 (mean difference (MD) = −47.38; 95% confidence interval (CI) = −56.74 to −38.02; p < 0.00001), first ambulation (MD = −41.65; 95% CI = −65.11 to −18.19; p = 0.0005), first urination (MD = −23.45; 95% CI = −32.16 to −14.74; p < 0.00001) and hospital discharge (MD = −29.39; 95% CI = −44.73 to −14.06; p = 0.0002) but has no substantial influence on onset time of anaesthesia (MD = 0.50; 95% CI = −1.71 to 2.70; p = 0.66), duration for motor blockade (MD = −42.56; 95% CI = −119.18 to 34.07; p = 0.28), pruritus (risk ratio (RR) = 2.17; 95% CI = 0.28 to 16.90; p = 0.46) or nausea (RR = 0.42; 95% CI = 0.10 to 1.81; p = 0.25). Conclusions: Fentanyl supplementation benefits postoperative recovery after knee arthroscopy.

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