The efficiency and safety of steroid addition to multimodal cocktail periarticular injection in knee joint arthroplasty: a meta-analysis of randomized controlled trials
The efficiency and safety of steroid addition to multimodal cocktail periarticular injection in knee joint arthroplasty: a meta-analysis of randomized controlled trials
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DOI：
10.1038/s41598-019-43540-9
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发表时间：
2019-05-07
影响因子：
4.6
通讯作者：
Lu, Wei
中科院分区：
文献类型：
--
作者：
Deng, Zhenhan;Li, Yusheng;Lu, Wei
类固醇经常用于术后疼痛缓解，但没有明确的证据。本研究旨在评估在接受膝关节置换术的患者中，将类固醇添加到多模式鸡尾酒关节周围注射（MCPI）中的疼痛管理效果，并评估其安全性。检索了Pubmed、Embase和科克伦图书馆，直至2018年4月。最终纳入了来自10项随机对照试验（RCT）的918例患者。与安慰剂组相比，应用类固醇可有效缓解术后第1天（POD）疼痛，降低术后第3天C反应蛋白（CRP）水平，改善术后第5天关节活动度（ROM），减少吗啡用量，实现早期直腿抬高（SLR），缩短住院时间（LOS）。关于不良反应，它没有增加术后感染、术后恶心呕吐（PONV）或其他并发症的风险。然而，在长期随访期间，未发现疼痛缓解、ROM或膝关节协会膝关节功能评分增加的显著差异。总体而言，该荟萃分析确保了膝关节置换术患者在术后早期使用类固醇联合MCPI的有效性和安全性。
Steroids are frequently used for postoperative pain relief without definite evidence. This study was conducted to assess the pain management effect of the addition of steroids to a multimodal cocktail periarticular injection (MCPI) in patients undergoing knee arthroplasty and evaluate their safety. Pubmed, Embase, and Cochrane Library were searched through April, 2018. A total of 918 patients from ten randomized controlled trials (RCTs) were ultimately included. Compared with placebo groups, steroids application could effectively relieve pain on postoperative day (POD) 1; decrease C-Reactive protein (CRP) level on POD3; improve range of motion (ROM) in postoperative 5 days; reduce morphine consumption, achieve earlier straight leg raising (SLR), and shorten the length of stay (LOS) in hospital. With regards to adverse effects, it did not increase the risk of postoperative infection, postoperative nausea and vomiting (PONV), or other complications. However, no significant difference in pain relief, ROM, or increased Knee Society Knee Function Scores were found during long-term follow up. Overall, this meta-analysis ensured the efficiency and safety of steroids with MCPI in knee arthroplasty patients during the early postoperative period.