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- Title
The efficacy and safety of selective COX-2 inhibitors for postoperative pain management in patients after total knee/hip arthroplasty: a meta-analysis.
- Authors
Jiang, Mingyang; Deng, Huachu; Chen, Xuxu; Lin, Yunni; Xie, Xiaoyong; Bo, Zhandong
- Abstract
Background: Many selective cyclooxygenase (COX-2) inhibitors are currently used in clinical practice. COX-2 inhibitors have good anti-inflammatory, analgesic, antipyretic effects, and gastrointestinal safety. However, the analgesic effects and adverse reactions of COX-2 after total knee/hip arthroplasty (TKA/THA) are not fully known. Objective: To evaluate the efficacy and safety of selective COX-2 inhibitors in postoperative pain management in patients receiving TKA/THA. Methods: Randomized controlled trials (RCTs) were retrieved from medical literature databases. Risk ratios (RR) Std mean difference (SMD) and 95% confidence intervals (CI) were calculated to analyze the primary and safety endpoints. Results: In total, 18 articles (23 trial comparisons) were retrieved comprising 3104 patients. Among them, 1910 patients (61.5%) were randomized to the experimental group whereas 1194 patients (38.5%) were randomized to the control group. The primary endpoints were the patients' VAS score at rest or on ambulation (within 3 days). We found that VAS score in patients that received selective COX-2 inhibitor was significantly lower compared to those of the control group. Conclusion: This meta-analysis shows that selective COX-2 inhibitor therapy is effective, safe, and reliable in relieving postoperative pain of THA/TKA.
- Subjects
CONFIDENCE intervals; META-analysis; NONSTEROIDAL anti-inflammatory agents; POSTOPERATIVE pain; TOTAL hip replacement; TOTAL knee replacement; PAIN management; SYSTEMATIC reviews; CYCLOOXYGENASE 2; PAIN measurement; VISUAL analog scale; TREATMENT effectiveness; DESCRIPTIVE statistics
- Publication
Journal of Orthopaedic Surgery & Research, 2020, Vol 15, Issue 1, p1
- ISSN
1749-799X
- Publication type
Article
- DOI
10.1186/s13018-020-1569-z