The First Affiliated Hospital of Traditional Chinese Medicine of Chengdu Medical College, Chengdu, Sichuan, China.
University of York, York, North Yorkshire, UK.
BMJ Open. 2023 Mar 16;13(3):e070998. doi: 10.1136/bmjopen-2022-070998.
Total knee arthroplasty (TKA) is currently regarded as an effective treatment for knee osteoarthritis, relieving patients' pain and significantly enhancing their quality of life and activity levels, allowing them to return to work and daily life after surgery. However, some TKA patients suffer from varying degrees of postoperative residual pain and opioid abuse, which negatively impacts their recovery and quality of life. It has been reported that preoperative treatment with multimodal analgesics improves postoperative pain and reduces opioid consumption. However, there is no conclusive evidence that pre-emptive analgesia provides the same benefits in TKA. In order to inform future research, this protocol focuses on the efficacy and safety of oral analgesics used in TKA pre-emptive analgesia.
We will search the literature on the involvement of pre-emptive analgesia in the management of pain in TKA from the PubMed, EMBASE, MEDLINE, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews, from their inception to 1 February 2023. Additionally, clinical registry platforms will be investigated to collect data for ongoing studies. Using the Cochrane Risk of Bias Tool, the quality assessment will be conducted. RevMan V.5.4 will be used for the meta-analysis. The statistic will be used to measure the percentage of total variability due to heterogeneity between studies. Where appropriate, subgroup and sensitivity analyses, assessment of evidence quality and publication bias will be conducted.
No ethical approval and consent is required for this systematic review. Moreover, the results of this systematic review will be disseminated through peer-reviewed publications and conference presentations.
CRD42022380782.
全膝关节置换术（TKA）目前被认为是治疗膝关节骨关节炎的有效方法，可缓解患者的疼痛，并显著提高其生活质量和活动水平，使他们在手术后能够重返工作和日常生活。然而，一些 TKA 患者术后仍存在不同程度的残留疼痛和阿片类药物滥用，这对他们的康复和生活质量产生负面影响。有报道称，术前使用多模式镇痛可以改善术后疼痛并减少阿片类药物的使用。然而，并没有确凿的证据表明预防性镇痛在 TKA 中具有相同的益处。为了为未来的研究提供信息，本方案侧重于 TKA 预防性镇痛中使用的口服镇痛药的疗效和安全性。
我们将从 PubMed、EMBASE、MEDLINE、Cochrane 对照试验中心注册库和 Cochrane 系统评价数据库中检索 TKA 疼痛管理中涉及预防性镇痛的文献，检索时间从建库至 2023 年 2 月 1 日。此外，还将调查临床注册平台以收集正在进行的研究数据。使用 Cochrane 偏倚风险工具进行质量评估。RevMan V.5.4 将用于荟萃分析。统计量 将用于测量由于研究之间的异质性导致的总变异性的百分比。在适当的情况下，将进行亚组和敏感性分析、证据质量评估和发表偏倚评估。
本系统评价不需要伦理批准和同意。此外，本系统评价的结果将通过同行评审出版物和会议报告进行传播。
PROSPERO 注册号：CRD42022380782。
