酮咯酸补充对膝关节镜检查疼痛控制的影响：随机对照试验的荟萃分析。

INTRODUCTION: The efficacy of ketorolac supplementation on pain control for knee arthroscopy remains controversial. We conduct a systematic review and meta-analysis to explore the impact of ketorolac supplementation on pain intensity after knee arthroscopy. METHODS: We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through September 2018 for randomized controlled trials (RCTs) assessing the effect of ketorolac supplementation vs placebo on pain management after knee arthroscopy. This meta-analysis is performed using the random-effect model. RESULTS: Ten RCTs involving 402 patients are included in the meta-analysis. Overall, compared with control group for knee arthroscopy, ketorolac supplementation is associated with notably reduced pain scores at 1 h (MD = -0.66; 95% CI = -1.12 to -0.21; P = 0.004) and 2 h (MD = -0.90; 95% CI = -1.74 to -0.07; P = 0.03), prolonged time for first analgesic requirement (MD = 1.94; 95% CI = 0.33 to 3.55; P = 0.02) and decreased number of analgesic requirement (RR = 0.41; 95% CI = 0.23 to 0.75; P = 0.003), but has no obvious impact on analgesic consumption (MD = -0.56; 95% CI = -1.14 to 0.02; P = 0.06), as well as nausea and vomiting (RR = 0.44; 95% CI = 0.12 to 0.21; P = 0.21). CONCLUSIONS: Ketorolac supplementation is effective to produce pain relief for knee arthroscopy.

简介：关于酮咯酸补充治疗对膝关节镜术后疼痛控制的疗效仍存在争议。我们进行了一项系统评价和荟萃分析，以探讨酮咯酸补充治疗对膝关节镜术后疼痛强度的影响。

方法：我们通过检索 PubMed、EMbase、Web of Science、EBSCO 和 Cochrane 图书馆数据库，收集了截至 2018 年 9 月评估膝关节镜术后酮咯酸补充治疗与安慰剂对照治疗疼痛管理效果的随机对照试验（RCT）。采用随机效应模型进行荟萃分析。

结果：共纳入 10 项 RCT 研究，涉及 402 例患者。总体而言，与膝关节镜术对照组相比，酮咯酸补充治疗可显著降低术后 1 小时（MD = -0.66；95%CI = -1.12 至 -0.21；P = 0.004）和 2 小时（MD = -0.90；95%CI = -1.74 至 -0.07；P = 0.03）的疼痛评分，首次需要镇痛药物的时间延长（MD = 1.94；95%CI = 0.33 至 3.55；P = 0.02）和镇痛药物需求次数减少（RR = 0.41；95%CI = 0.23 至 0.75；P = 0.003），但对镇痛药物消耗（MD = -0.56；95%CI = -1.14 至 0.02；P = 0.06）以及恶心呕吐（RR = 0.44；95%CI = 0.12 至 0.21；P = 0.21）无明显影响。

结论：酮咯酸补充治疗对膝关节镜术有效。