Efficacy of Additional Corticosteroid in a Multimodal Cocktail for Postoperative Analgesia Following Total Knee Arthroplasty: A Meta-Analysis of Randomized Controlled Trials

Autor:	Congxin You, Xiping Chai, Haiping Liu, Changde Wang
Rok vydání:	2019
Předmět:	Nausea medicine.drug_class Postoperative pain Total knee arthroplasty Cochrane Library law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Adrenal Cortex Hormones 030202 anesthesiology law Humans Pain Management Medicine Range of Motion Articular Arthroplasty Replacement Knee Randomized Controlled Trials as Topic Pain Postoperative business.industry Length of Stay Analgesics Opioid Anesthesiology and Pain Medicine Meta-analysis Anesthesia Vomiting Corticosteroid Analgesia medicine.symptom business 030217 neurology & neurosurgery
Zdroj:	Pain Practice. 19:316-327
ISSN:	1530-7085
DOI:	10.1111/papr.12740
Popis:	Local injection of a multimodal cocktail including corticosteroid is commonly used for postoperative pain following total knee arthroplasty (TKA). However, it is inconclusive whether additional corticosteroid is beneficial. This meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the efficacy of an additional, local injection of corticosteroid in terms of pain relief and knee function recovery after TKA.RCTs in electronic literature databases including PubMed, Web of Science, Embase, and Cochrane Library were systematically searched. Of 1,628 records identified, 9 RCTs involving 727 knees were eligible for data extraction and meta-analysis.Local injection of a multimodal cocktail including corticosteroid did not contribute to pain relief within 12 hours postoperatively (P 0.05). However, from 24 hours to 72 hours, it significantly decreased pain scores (P 0.05, all) at rest and reduced total rescue opioid consumption postoperatively (P 0.05). Knee range of motion (ROM) was improved at postoperative day 1 (POD1) and POD2 (P 0.05), and hospital stay (P 0.05) was shortened after local injection of corticosteroid. However, the other outcomes, including knee ROM after POD2, C-reactive protein level, Knee Society score, postoperative nausea and vomiting, and wound complication occurrences, were not significantly different (P 0.05, all).Additional corticosteroid added to a multimodal cocktail improved postoperative pain, enhanced knee functional recovery, and shortened hospital stays following TKA, but local injection of corticosteroids had no effect on reducing nausea and vomiting based on our outcomes.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::61b564605bf274d31eea6f5c9ef3f9e8 https://doi.org/10.1111/papr.12740 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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