Efficacy of intra-articular ketorolac for pain control in arthroscopic surgeries: a systematic review and meta-analysis
Abstract Background The current systematic review and meta-analysis aimed to synthesize evidence on the efficacy of intra-articular ketorolac for patients undergoing arthroscopic surgeries. Methods PubMed, Embase, ScienceDirect, and Google Scholar databases were searched for randomized controlled tr...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-11-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-021-02833-4 |
| _version_ | 1828118763245928448 |
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| author | Jingjing Yang Bin Ni Xiaoyan Fu |
| author_facet | Jingjing Yang Bin Ni Xiaoyan Fu |
| author_sort | Jingjing Yang |
| collection | DOAJ |
| description | Abstract Background The current systematic review and meta-analysis aimed to synthesize evidence on the efficacy of intra-articular ketorolac for patients undergoing arthroscopic surgeries. Methods PubMed, Embase, ScienceDirect, and Google Scholar databases were searched for randomized controlled trials assessing the analgesic effect of intra-articular ketorolac for arthroscopic surgery of hip/knee or shoulder joint. Results Six studies were included. Two studies were on shoulder arthroscopy, while others were on knee joint. Meta-analysis revealed that patients receiving intra-articular ketorolac had significantly lower pain scores at 2–4 h (MD: − 0.58 95% CI: − 0.88, − 0.19 I 2 = 49% p = 0.002), 6–8 h (MD: − 0.77 95% CI: − 1.11, − 0.44 I 2 = 31% p < 0.00001), 12 h (MD: − 0.94 95% CI: − 1.21, − 0.67 I 2 = 0% p < 0.00001), and 24 h (MD: − 1.28 95% CI: − 1.85, − 0.71 I 2 = 84% p < 0.00001) as compared to the control group (Certainty of evidence: low-moderate). Analysis of three studies revealed a tendency of reduced analgesic consumption in patients receiving intra-articular ketorolac, but the difference did not reach statistical significance (MD: − 0.53 95% CI: − 1.07, 0.02 I 2 = 55% p = 0.06). Conclusions Preliminary evidence from a limited number of studies indicates that additional intra-articular ketorolac to multimodal analgesia results in reduced pain scores up to 24 h after arthroscopic surgery. The clinical relevance of small changes in pain scores is debatable. Also, scarce data suggest that consumption of analgesics may not be reduced with intra-articular ketorolac. Since pain scores can be influenced by the primary diagnosis and dose of ketorolac, the results should be interpreted with caution. The certainty of the evidence is low-moderate. There is a need for future RCTs to further strengthen current evidence. |
| first_indexed | 2024-04-11T13:37:52Z |
| format | Article |
| id | doaj.art-a35259aa83cf4cca9f0b6d6a382584aa |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T13:37:52Z |
| publishDate | 2021-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-a35259aa83cf4cca9f0b6d6a382584aa2022-12-22T04:21:24ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-11-011611910.1186/s13018-021-02833-4Efficacy of intra-articular ketorolac for pain control in arthroscopic surgeries: a systematic review and meta-analysisJingjing Yang0Bin Ni1Xiaoyan Fu2Department of Pharmacy, Hangzhou Third People’s HospitalDepartment of Pharmacy, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of MedicineDepartment of Pharmacy, Hangzhou Third People’s HospitalAbstract Background The current systematic review and meta-analysis aimed to synthesize evidence on the efficacy of intra-articular ketorolac for patients undergoing arthroscopic surgeries. Methods PubMed, Embase, ScienceDirect, and Google Scholar databases were searched for randomized controlled trials assessing the analgesic effect of intra-articular ketorolac for arthroscopic surgery of hip/knee or shoulder joint. Results Six studies were included. Two studies were on shoulder arthroscopy, while others were on knee joint. Meta-analysis revealed that patients receiving intra-articular ketorolac had significantly lower pain scores at 2–4 h (MD: − 0.58 95% CI: − 0.88, − 0.19 I 2 = 49% p = 0.002), 6–8 h (MD: − 0.77 95% CI: − 1.11, − 0.44 I 2 = 31% p < 0.00001), 12 h (MD: − 0.94 95% CI: − 1.21, − 0.67 I 2 = 0% p < 0.00001), and 24 h (MD: − 1.28 95% CI: − 1.85, − 0.71 I 2 = 84% p < 0.00001) as compared to the control group (Certainty of evidence: low-moderate). Analysis of three studies revealed a tendency of reduced analgesic consumption in patients receiving intra-articular ketorolac, but the difference did not reach statistical significance (MD: − 0.53 95% CI: − 1.07, 0.02 I 2 = 55% p = 0.06). Conclusions Preliminary evidence from a limited number of studies indicates that additional intra-articular ketorolac to multimodal analgesia results in reduced pain scores up to 24 h after arthroscopic surgery. The clinical relevance of small changes in pain scores is debatable. Also, scarce data suggest that consumption of analgesics may not be reduced with intra-articular ketorolac. Since pain scores can be influenced by the primary diagnosis and dose of ketorolac, the results should be interpreted with caution. The certainty of the evidence is low-moderate. There is a need for future RCTs to further strengthen current evidence.https://doi.org/10.1186/s13018-021-02833-4ArthroscopyKnee jointShoulder jointPainNSAIDs |
| spellingShingle | Jingjing Yang Bin Ni Xiaoyan Fu Efficacy of intra-articular ketorolac for pain control in arthroscopic surgeries: a systematic review and meta-analysis Journal of Orthopaedic Surgery and Research Arthroscopy Knee joint Shoulder joint Pain NSAIDs |
| title | Efficacy of intra-articular ketorolac for pain control in arthroscopic surgeries: a systematic review and meta-analysis |
| title_full | Efficacy of intra-articular ketorolac for pain control in arthroscopic surgeries: a systematic review and meta-analysis |
| title_fullStr | Efficacy of intra-articular ketorolac for pain control in arthroscopic surgeries: a systematic review and meta-analysis |
| title_full_unstemmed | Efficacy of intra-articular ketorolac for pain control in arthroscopic surgeries: a systematic review and meta-analysis |
| title_short | Efficacy of intra-articular ketorolac for pain control in arthroscopic surgeries: a systematic review and meta-analysis |
| title_sort | efficacy of intra articular ketorolac for pain control in arthroscopic surgeries a systematic review and meta analysis |
| topic | Arthroscopy Knee joint Shoulder joint Pain NSAIDs |
| url | https://doi.org/10.1186/s13018-021-02833-4 |
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