Zallipalli Sri Nikhil, Bethi Rakesh Reddy, Kandru Madhuri, Dendukuri Nikith Kashyap, Gandla Geethanjali, Vemuri Sree Sai Siddhardha, Peri Harish, Linga Saichand
Department of Surgery, Star Hospitals, Hyderabad, IND.
Department of Surgery, Bharati Vidyapeeth University Medical College & Hospital, Sangli, IND.
Cureus. 2022 Dec 9;14(12):e32339. doi: 10.7759/cureus.32339. eCollection 2022 Dec.
Total knee arthroplasty (TKA) or total hip arthroplasty (THA) are frequent procedures used to relieve the symptoms of hip or knee joint dysfunction, enhance disease recovery, and boost patients' quality of life. Nevertheless, postoperative pain has been a significant disadvantage since it strongly impacts patients' postoperative recovery. Parecoxib has been demonstrated to be useful in the management of postoperative pain in a variety of surgical procedures. While parecoxib can help with postoperative pain, its analgesic and unfavourable effects in TKA/THA patients have not been well studied.
A systematic search of peer-reviewed articles was conducted through the PubMed database, Google Scholar, and Cochrane library to retrieve related studies published in the English language that met inclusion and exclusion criteria. The publication date was restricted to the past 10 years (2012-2022). Results were analyzed using Review Manager software (RevMan version 5.4.1, The Cochrane Collaboration, 2020). The quality of the studies included was assessed using Jadad scores. Risk ratios (RR) standard mean difference (SMD) and 95% confidence intervals (CI) were calculated to analyze the primary and secondary endpoints.
Eleven randomized controlled trials covering 1911 patients who underwent TKA/THA were selected. The pooled results indicated that the parecoxib group has lower visual analogue scale (VAS) scores than the placebo group. However, there was no significant difference in the secondary endpoint. The Jadad scores ranged from 3 to 5 and most of the studies were of high quality.
The results of our meta-analysis indicate that parecoxib has a better analgesic effect compared to placebo. It alleviates postoperative orthopaedic pain without raising the risk of adverse events.
全膝关节置换术（TKA）或全髋关节置换术（THA）是常用于缓解髋关节或膝关节功能障碍症状、促进疾病康复以及提高患者生活质量的手术。然而，术后疼痛一直是一个显著的不利因素，因为它严重影响患者的术后恢复。帕瑞昔布已被证明在多种外科手术的术后疼痛管理中有效。虽然帕瑞昔布有助于缓解术后疼痛，但其在TKA/THA患者中的镇痛效果和不良反应尚未得到充分研究。
通过PubMed数据库、谷歌学术和Cochrane图书馆对同行评审文章进行系统检索，以检索符合纳入和排除标准的英文相关研究。出版日期限制在过去10年（2012 - 2022年）。使用Review Manager软件（RevMan版本5.4.1，Cochrane协作网，2020年）分析结果。使用Jadad评分评估纳入研究的质量。计算风险比（RR）、标准平均差（SMD）和95%置信区间（CI）以分析主要和次要终点。
选择了11项涵盖1911例接受TKA/THA患者的随机对照试验。汇总结果表明，帕瑞昔布组的视觉模拟评分（VAS）低于安慰剂组。然而，次要终点没有显著差异。Jadad评分范围为3至5，大多数研究质量较高。
我们的荟萃分析结果表明，与安慰剂相比，帕瑞昔布具有更好的镇痛效果。它可减轻术后骨科疼痛，而不会增加不良事件的风险。
