scholarly journals Is intraoperative corticosteroid a good choice for postoperative pain relief in total joint arthroplasty? A meta-analysis of 11 randomized controlled trials

Medicine ◽  
2021 ◽  
Vol 100 (40) ◽  
pp. e27468
Author(s):  
Lu-kai Zhang ◽  
Fang-bing Zhu ◽  
Huan-huan Gao ◽  
Lei Zhang ◽  
Ren-fu Quan
2019 ◽  
Author(s):  
Fengxi Hao ◽  
Zhongyuan Fan ◽  
Feng Chen ◽  
Yongbo Yu ◽  
Yuanzhong Ren ◽  
...  

Abstract Objective: To systematically evaluate the efficacy index and adverse reactions of dezocine in postoperative pain relief, provide statistical theoretical support for guiding clinical application. Methods: We extracted and analyzed multiple data of patients from the PubMed, Embase, The Cochrane Library and China National Knowledge Infrastructure (CNKI) for use in randomized controlled trials of various surgical postoperative pain relief. We used meta-analysis to study several measures of efficacy and safety of dezocine, including visual analogue score (VAS), Ramsay sedation score, mean arterial pressure (MAP), heart rate (HR), Pulse Oxygen Saturation (SpO2) and the incidence of adverse events(AEs). The material data were calculated and analyzed using Review Manager 5.3. Results: After exclusion of literature that did not meet the inclusion criteria, our analysis included 14 randomized controlled trials. The Mean Difference (MD) of VAS at 1 h/6 h/24h between the dezocine group and the placebo group was -1.37 (95% CI -2.07,-0.67, P=0.0001),-0.52 (95% CI -1.04,0.01, P=0.05),-0.10 (95% CI -0.39,0.20, P=0.52), respectively. The MD of Ramsay sedation score at 2h/8h was 1.21 (95% CI 0.67,1.75, P<0.0001) and -0.17 (95% CI -0.59,0.26, P=0.44). The MD of MAP at T0/T1/T2 was -0.28 (95% CI -2.46,1.89, P=0.80),-2.66 (95% CI -5.07,-0.25, P=0.03),-4.53 (95% CI -6.17,-2.89, P<0.00001). The MD of HR at T0/T1/T2 was -2.26(95% CI -4.32,-0.21, P=0.03),-3.58(95% CI -5.21,-1.96, P<0.0001),-3.75 (95% CI -11.55,4.04, P=0.35). The MD of SpO2 at T0/T1 was -0.90(95% CI -1.77,-0.03, P=0.04) and 0.36(95% CI 0.02,0.71, P=0.04).The odds ratio (OR) of AEs was 0.53(95% CI 0.39,0.71, P<0.0001). Conclusion: Dezocine shows appropriate anesthetic efficacy and fewer adverse effects, which can reduce postoperative pain effectively.


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