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膝关节镜检查后关节内镇痛药的疗效和安全性比较:一项贝叶斯网络荟萃分析方案。

Comparative efficacy and safety of intra-articular analgesics after knee arthroscopy: a Bayesian network meta-analysis protocol.

机构信息

Orthopaedics, Xiangya Hospital Central South University, Changsha, China.

Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan, China.

出版信息

BMJ Open. 2020 Sep 17;10(9):e035346. doi: 10.1136/bmjopen-2019-035346.


DOI:10.1136/bmjopen-2019-035346
PMID:32948544
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7500288/
Abstract

INTRODUCTION: Most of the patients who received arthroscopic knee surgery will suffer moderate to severe pain, which can delay the rehabilitation process and increase the risk of postoperative complications. Therefore, seeking a safe and effective postoperative analgesia is necessary for promoting the application of arthroscopic surgery. This protocol aims to detail a planned systematic review and meta-analysis on the comparative efficacy and safety of single-dose intra-articular injection of analgesics for pain relief after knee arthroscopy. METHOD AND ANALYSIS: PubMed, Embase, Web of Science and Cochrane Library will be searched from inception to 1 June 2020 to retrieve randomised controlled trials (RCTs) that compared the commonly used single-dose intra-articular analgesics (ie, morphine; bupivacaine (including levobupivacaine); ropivacaine and magnesium alone or in combination) with placebo or between each other for postoperative pain relief among patients who had received knee arthroscopy. The primary outcome is pain intensity at 2-hour and 24-hour postoperatively; the secondary outcomes include side effects (eg, knee effusion, nausea, vomiting and flushing), the number of patients requiring supplementary analgesia and the time to first analgesic request. The methodological quality of the included RCTs will be assessed based on the Cochrane risk of bias table. The Bayesian network meta-analysis will be conducted using WinBUGS V.1.4.3. ETHICS AND DISSEMINATION: Since no private or confidential patient data will be contained in the reporting, approval from an ethics committee is not required. Our study raises no ethical issue, and the results will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42019130876.

摘要

简介:大多数接受关节镜膝关节手术的患者会遭受中重度疼痛,这可能会延迟康复过程并增加术后并发症的风险。因此,寻求安全有效的术后镇痛对于促进关节镜手术的应用是必要的。本方案旨在详细描述一项关于关节镜术后单次关节内注射镇痛剂缓解疼痛的疗效和安全性的计划系统评价和荟萃分析。

方法和分析:将从建库到 2020 年 6 月 1 日在 PubMed、Embase、Web of Science 和 Cochrane Library 中检索随机对照试验(RCT),比较常用的单次关节内镇痛剂(即吗啡;布比卡因(包括左旋布比卡因);罗哌卡因和单独或联合使用的镁)与安慰剂或彼此之间用于接受膝关节镜检查的患者术后疼痛缓解的效果。主要结局是术后 2 小时和 24 小时的疼痛强度;次要结局包括副作用(如膝关节积液、恶心、呕吐和潮红)、需要补充镇痛的患者人数和首次要求镇痛的时间。根据 Cochrane 偏倚风险表评估纳入 RCT 的方法学质量。将使用 WinBUGS V.1.4.3 进行贝叶斯网络荟萃分析。

伦理和传播:由于报告中不会包含任何私人或机密的患者数据,因此不需要伦理委员会的批准。我们的研究没有伦理问题,研究结果将发表在同行评议的期刊上。

PROSPERO 注册号:CRD42019130876。

相似文献

[1]
Comparative efficacy and safety of intra-articular analgesics after knee arthroscopy: a Bayesian network meta-analysis protocol.

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引用本文的文献

[1]
Oxycodone-paracetamol tablet exhibits increased analgesic efficacy for acute postoperative pain, higher satisfaction and comparable safety profiles compared with celecoxib in patients underwent arthroscopic knee surgery.

Inflammopharmacology. 2021-8

本文引用的文献

[1]
Relative efficacy and safety of topical non-steroidal anti-inflammatory drugs for osteoarthritis: a systematic review and network meta-analysis of randomised controlled trials and observational studies.

Br J Sports Med. 2018-2-7

[2]
Analgesic effect and safety of single-dose intra-articular magnesium after arthroscopic surgery: a systematic review and meta-analysis.

Sci Rep. 2016-11-30

[3]
A Single-Dose Intra-Articular Morphine plus Bupivacaine versus Morphine Alone following Knee Arthroscopy: A Systematic Review and Meta-Analysis.

PLoS One. 2015-10-16

[4]
Single-dose intra-articular bupivacaine plus morphine versus bupivacaine alone after arthroscopic knee surgery: a meta-analysis of randomized controlled trials.

Knee Surg Sports Traumatol Arthrosc. 2017-3

[5]
Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms.

BMJ. 2015-6-16

[6]
Single-dose intra-articular bupivacaine plus morphine after knee arthroscopic surgery: a meta-analysis of randomised placebo-controlled studies.

BMJ Open. 2015-6-15

[7]
Single-dose intra-articular ropivacaine after arthroscopic knee surgery decreases post-operative pain without increasing side effects: a systematic review and meta-analysis.

Knee Surg Sports Traumatol Arthrosc. 2016-5

[8]
Single administration of intra-articular bupivacaine in arthroscopic knee surgery: a systematic review and meta-analysis.

BMC Musculoskelet Disord. 2015-2-10

[9]
Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement.

Syst Rev. 2015-1-1

[10]
Electrical stimulation for pain relief in knee osteoarthritis: systematic review and network meta-analysis.

Osteoarthritis Cartilage. 2015-2

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