Ryan Thomas, Hodge Anthony, Holyoak Rhys, Vlok Ruan, Melhuish Thomas, Binks Matthew, Hurtado Glenn, White Leigh
Department of Orthopaedics, John Hunter Hospital, Newcastle, New South Wales, Australia.
School of Medicine Sydney, Wagga Wagga Rural Clinical School, The University of Notre Dame Australia, Wagga Wagga, New South Wales, Australia.
ANZ J Surg. 2019 Jul;89(7-8):827-832. doi: 10.1111/ans.14920. Epub 2019 Jan 26.
Arthroscopic knee surgery is a common technique used in Australia. Post-operative pain is common and can lead to delayed discharge and impair early mobilization. Use of local anaesthesia can reduce pain while avoiding systemic side effects. This systematic review and meta-analysis aimed to establish the use of tramadol as an adjunct to intra-articular local anaesthetic infiltration in knee arthroscopy in the current literature.
Two independent reviewers performed a systematic search of four databases, where 24 articles were identified with six studies (four high-quality and two low-quality randomized controlled trials), with a total of 334 patients were included for analysis. RevMan 5.3 software (The Nordic Cochrane Centre, Copenhagen, Denmark) was used to perform the data analysis. The studies included focused on outcomes such as pain scores, breakthrough analgesia, total analgesia, time to discharge and adverse events related to the use of tramadol as an adjunctive therapy.
This study found that using tramadol as an adjunct to intra-articular local anaesthetic infiltration in arthroscopic knee surgery reduced post-operative pain and increased time to breakthrough analgesia without an increase in side effects.
This meta-analysis suggests that tramadol is an efficacious adjunct for use in intra-articular local anaesthetic infiltration following arthroscopic knee surgery.
关节镜下膝关节手术是澳大利亚常用的一项技术。术后疼痛很常见，可能导致出院延迟并影响早期活动。使用局部麻醉可以减轻疼痛，同时避免全身副作用。本系统评价和荟萃分析旨在确定在当前文献中曲马多作为关节镜下膝关节手术关节内局部麻醉浸润辅助用药的情况。
两名独立的评价者对四个数据库进行了系统检索，共识别出24篇文章，其中有6项研究（4项高质量和2项低质量随机对照试验），共纳入334例患者进行分析。使用RevMan 5.3软件（丹麦哥本哈根北欧 Cochrane 中心）进行数据分析。纳入的研究重点关注疼痛评分、突破性镇痛、总镇痛效果、出院时间以及与曲马多作为辅助治疗相关的不良事件等结局。
本研究发现，在关节镜下膝关节手术中，将曲马多作为关节内局部麻醉浸润的辅助用药可减轻术后疼痛，并延长突破性镇痛时间，且不增加副作用。
这项荟萃分析表明，曲马多是关节镜下膝关节手术后关节内局部麻醉浸润的一种有效辅助用药。
