1. Single-dose intra-articular bupivacaine plus morphine versus bupivacaine alone after arthroscopic knee surgery: a meta-analysis of randomized controlled trials.
- Author
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Yang Y, Zeng C, Wei J, Li H, Yang T, Deng ZH, Li YS, Yang TB, and Lei GH
- Subjects
- Analgesics, Opioid adverse effects, Anesthetics, Local adverse effects, Bupivacaine adverse effects, Female, Humans, Injections, Intra-Articular, Male, Morphine adverse effects, Pain Management, Pain Measurement, Randomized Controlled Trials as Topic, Analgesics, Opioid administration & dosage, Anesthetics, Local administration & dosage, Arthroscopy adverse effects, Bupivacaine administration & dosage, Knee surgery, Morphine administration & dosage, Pain, Postoperative prevention & control
- Abstract
Purpose: The purpose of this meta-analysis was to compare the efficacy and safety of single-dose intra-articular bupivacaine plus morphine versus bupivacaine alone for pain management following arthroscopic knee surgery., Method: A comprehensive literature search was conducted to identify randomized controlled trials that used single-dose intra-articular bupivacaine plus morphine and bupivacaine alone for post-operative pain, using MEDLINE (1966-2014), Cochrane Library and EMBASE databases. The weighted mean difference (WMD), relative risk (RR) and their corresponding 95 % confidence intervals (CIs) were calculated using RevMan statistical software., Result: A total of twenty-nine trials (n = 1167) were included. The post-operative visual analog scale (VAS) pain score of the bupivacaine plus morphine group compared with the bupivacaine alone group was significantly lower (WMD -1.15, 95 % CI -1.67 to -0.63, p < 0.0001). As far as safety, there was no significant difference in side effects between the two groups (RR 1.10, 95 % CI 0.59-2.04, n.s.). Sensitivity analyses suggested that the results of these two primary outcomes were stable and reliable. However, the current evidence did not suggest a superior effect with respect to the time to first analgesic request (WMD 51.33, 95 % CI -110.99 to 213.65, n.s.) and the number of patients requiring supplementary analgesia (RR 1.13, 95 % CI 0.92-1.39, n.s.)., Conclusions: On the basis of the currently available literature, this study is the first to suggest that single-dose intra-articular bupivacaine plus morphine was shown to be significantly better than bupivacaine alone at relieving post-operative pain after arthroscopic knee surgery without increasing the short-term side effects. Routine use of single-dose intra-articular bupivacaine plus morphine is an effective way for pain management after arthroscopic knee surgery., Level of Evidence: II.
- Published
- 2017
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