Department of Bone and Joint Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Guangxi Medical University, Nanning, Guangxi, China.
J Orthop Surg Res. 2020 Feb 5;15(1):39. doi: 10.1186/s13018-020-1569-z.
Many selective cyclooxygenase (COX-2) inhibitors are currently used in clinical practice. COX-2 inhibitors have good anti-inflammatory, analgesic, antipyretic effects, and gastrointestinal safety. However, the analgesic effects and adverse reactions of COX-2 after total knee/hip arthroplasty (TKA/THA) are not fully known.
To evaluate the efficacy and safety of selective COX-2 inhibitors in postoperative pain management in patients receiving TKA/THA.
Randomized controlled trials (RCTs) were retrieved from medical literature databases. Risk ratios (RR) Std mean difference (SMD) and 95% confidence intervals (CI) were calculated to analyze the primary and safety endpoints.
In total, 18 articles (23 trial comparisons) were retrieved comprising 3104 patients. Among them, 1910 patients (61.5%) were randomized to the experimental group whereas 1194 patients (38.5%) were randomized to the control group. The primary endpoints were the patients' VAS score at rest or on ambulation (within 3 days). We found that VAS score in patients that received selective COX-2 inhibitor was significantly lower compared to those of the control group.
This meta-analysis shows that selective COX-2 inhibitor therapy is effective, safe, and reliable in relieving postoperative pain of THA/TKA.
目前临床上有许多选择性环氧化酶（COX-2）抑制剂。COX-2 抑制剂具有良好的抗炎、镇痛、解热作用，且胃肠道安全性较好。然而，COX-2 在全膝关节/髋关节置换术（TKA/THA）后的镇痛效果和不良反应尚不完全清楚。
评估选择性 COX-2 抑制剂在 TKA/THA 术后疼痛管理中的疗效和安全性。
检索医学文献数据库中的随机对照试验（RCT）。计算风险比（RR）、标准均数差（SMD）和 95%置信区间（CI）来分析主要和安全性终点。
共检索到 18 篇文章（23 项试验比较），包含 3104 名患者。其中，1910 名患者（61.5%）被随机分配到实验组，1194 名患者（38.5%）被随机分配到对照组。主要终点为患者静息或活动时的 VAS 评分（3 天内）。我们发现，接受选择性 COX-2 抑制剂治疗的患者 VAS 评分明显低于对照组。
这项荟萃分析表明，选择性 COX-2 抑制剂治疗在缓解 THA/TKA 术后疼痛方面是有效、安全和可靠的。
