Dataset Information

Preoperative intravenous glucocorticoids can reduce postoperative acute pain following total knee arthroplasty: A meta-analysis.

ABSTRACT:

Background

The ability of preoperative intravenous glucocorticoids to control pain after total knee arthroplasty (TKA) has been examined in many studies, but it remains controversial. Therefore, we undertook a meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of preoperative intravenous glucocorticoids for postoperative pain management after TKA.

Methods

We systematically searched RCTs from electronic databases, including PubMed, Embase, Web of Science, the Cochrane Library, the Chinese Wanfang Database, and the China National Knowledge Infrastructure database. The outcomes included visual analogue scale (VAS) scores at 6, 12, 24, 48, and 72?hours after TKA; the occurrence of postoperative nausea and vomiting (PONV); blood glucose at 6 and 24?hours after TKA; and the occurrence of infection.

Results

Of the identified studies, a total of 11 RCTs involving 1000 patients (glucocorticoids?=?501, control?=?499) were included in this meta-analysis. Compared with a placebo, preoperative intravenous glucocorticoids significantly reduced VAS scores at 6, 12, 24, and 48?hours, with decreases of 3.63 points, 6.81 points, 10.40 points, and 3.15 points, respectively, on a 110-point VAS. Moreover, intravenous glucocorticoids were associated with significant decreases of 19.4% and 16.8% in the occurrence of nausea and vomiting, respectively. However, intravenous glucocorticoids were also associated with increased blood glucose with no clinical importance at 6?hours after TKA. No significant difference was found in the occurrence of infection or in blood glucose at 24?hours after TKA.

Conclusion

Preoperative intravenous glucocorticoids are an effective and safe method to reduce postoperative pain and PONV in patients following TKA. More studies are necessary to identify the optimal dose and type of glucocorticoids for maximal pain control.

SUBMITTER: Liu X

PROVIDER: S-EPMC5585486 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Preoperative intravenous glucocorticoids can reduce postoperative acute pain following total knee arthroplasty: A meta-analysis.

Liu Xiangcheng X Liu Jinglong J Sun Ganghe G

Medicine 20170901 35

<h4>Background</h4>The ability of preoperative intravenous glucocorticoids to control pain after total knee arthroplasty (TKA) has been examined in many studies, but it remains controversial. Therefore, we undertook a meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of preoperative intravenous glucocorticoids for postoperative pain management after TKA.<h4>Methods</h4>We systematically searched RCTs from electronic databases, including PubMed, Embase, Web ...[more]

PMID: 28858092

Similar Datasets

Project description:BackgroundGlucocorticoids are increasingly used perioperatively, principally to prevent postoperative nausea and vomiting (PONV), and acute postoperative pain following total hip arthroplasty (THA). The authors hypothesized that preoperative intravenous glucocorticoids is associated with less pain scores and PONV without increasing the complications after THA.MethodsFour databases (PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science) were searched with the limitations of randomized controlled trials (RCTs). The search cutoff date was set at November 6, 2016. Participants were patients who were prepared for primary THA. Intervention was preoperative intravenous glucocorticoids for postoperative pain control. Outcomes including the visual analog scale (VAS) scores at the postanesthesia care unit (PACU) and at 24 and 48 hours post operation, the occurrence of PONV and total morphine consumption were recorded. We calculated risk ratio (RR) with a 95% confidence interval (CI) for dichotomous outcomes, and the weighted mean difference (WMD) with a 95% CI for continuous outcomes.ResultsA total of 6 studies were evaluated, which included 297 patients who underwent hip surgery with intravenous glucocorticoid treatment and control patients who underwent hip surgery without glucocorticoid treatment. Pooled results indicated that intravenous glucocorticoid treatment was associated with a reduction of VAS scores at the PACU (WMD = -9.06, 95% CI -12.67 to -5.45, P = .000) and total morphine consumption by 15.68 mg (WMD = -15.68, 95% CI -24.60 to -6.75, P = .001). No significant difference was observed in the VAS scores at 24 and 48 hours between the intravenous glucocorticoid and placebo treatments. Intravenous steroids can decrease the occurrence of PONV (RR = 0.46, 95% CI 0.26-0.82, P = .029).ConclusionIntravenous glucocorticoid treatment can decrease early pain intensity and PONV after THA. However, the evidence for the use of glucocorticoids is limited by the low number of studies and variation in dosing regimens. Thus, additional high-quality RCTs are needed to identify the optimal drug protocol and determine the safety of intravenous glucocorticoids.

Dataset Information

Preoperative intravenous glucocorticoids can reduce postoperative acute pain following total knee arthroplasty: A meta-analysis.

Background

Methods

Results

Conclusion

Publications

Preoperative intravenous glucocorticoids can reduce postoperative acute pain following total knee arthroplasty: A meta-analysis.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets