Efficacy and safety of selective COX -2 inhibitors for preemptive analgesia in patients undergoing total hip/knee arthroplasty：a meta -analysis
- VernacularTitle:选择性COX-2抑制剂用于髋/膝关节置换术超前镇痛有效性及安全性的Meta分析
- Author:
Qing LIU
1
,
2
;
Xiaodong LI
3
;
Wangjun QIN
2
;
Min MAO
2
Author Information
1. Dept. of Pharmacy，Qingdao Huangdao District People’s Hospital，Shandong Qingdao 266499，China
2. Dept. of Pharmacy，China-Japan Friendship Hospital，Beijing 100029，China
3. Dept. of Joint Surgery，Qingdao Huangdao District People’s Hospital，Shandong Qingdao 266499，China
- Publication Type:Journal Article
- Keywords:
total hip arthroplasty;
total knee arthroplasty;
selective COX -2 inhibitor;
preemptive analgesia;
meta-analysis
- From:
China Pharmacy
2022;33(19):2409-2413
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To systematically evaluate the efficacy and safety of selective COX -2 inhibitors for preemptive analgesia in patients undergoing total hip/knee arthroplasty （THA/TKA），and to provide evidence -based reference for clinical drug use. METHODS Retrieved from CNKI ，VIP，CBM，Wanfang database ，PubMed，Embase，Scopus，Web of Science and Cochrane library ，randomized controlled trials about selective COX -2 inhibitors for preemptive analgesia combined with post - operative analgesia of THA/TKA （trial group ）versus post -operative analgesia （control group ）were collected during the inception to February 15，2022. After screening the literature and extracting the data ，the RCT bias risk assessment tool recommended by the Cochrane System Evaluator ’s Manual 5.1.0 was used to evaluate the quality of the included literature . Meta-analysis was performed by using RevMan 5.3 software. RESULTS Six RCTs involving 916 patients were included . The visual analog （VAS）scale scores of pain at rest [MD＝－0.20，95%CI（－0.30，－0.10），P＜0.000 1]，VAS scores of pain at movement [MD＝－0.20，95%CI （－0.27，－0.13），P＜0.000 01]，total consumption of patient controlled analgesia （PCA） [MD＝－5.89，95%CI（－8.98， －2.80），P＝0.000 2]，and the incidence of postoperative nausea and vomiting [RR＝0.79，95%CI（0.65，0.95），P＝0.01] in trial group were significantly lower than control group . CONCLUSIONS Compared with postoperative administration alone ，preemptive plus postoperative analgesia with selective COX -2 inhibitor can significantly alleviate the early postoperative pain ，reduce the total consumption of PCA and the incidence of postoperative nausea and vomiting in THA/TKA patients .
