SynthesisMedicine2019
Effect of morphine added to multimodal cocktail on infiltration analgesia in total knee arthroplasty: A meta-analysis of randomized controlled trials.
Synthesis in Medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Pooled it
- HTX-011 in Combination with Multimodal Analgesic Regimen Minimized Severe Pain and Opioid Use after Total Knee Arthroplasty in an Open-Label Study.The journal of knee surgery · 2023Trial
- Comparison of iPACK and periarticular block with adductor block alone after total knee arthroplasty: a randomized clinical trial.Journal of anesthesia · 2022Trial
- Does Surgical-site Multimodal Drug Injection After Palmar Plating of Distal Radius Fractures Improve Pain Scores?Clinical orthopaedics and related research · 2020Trial
- Therapeutic Efficacy of Modified Cocktail Analgesia After Minimally Invasive Chevron Osteotomy for Hallux Valgus: A Retrospective Case Series Study.Local and regional anesthesia · 2026Article
- Review
- Effect of periarticular cocktail of analgesia on immediate post-operative clinical outcomes after bilateral simultaneous total knee arthroplasty: a randomized placebo controlled, split-body superiority trial.Journal of clinical orthopaedics and trauma · 2024Article
- Periarticular infiltration used in total joint replacements: an update and review article.Journal of orthopaedic surgery and research · 2023Review
- Perioperative multimodal analgesic injection for patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion surgery.Spine deformity · 2023Article
- Multimodal cocktail analgesic injection in PIVD with lower limb radiculopathy - A mixed design cohart study.Journal of clinical orthopaedics and trauma · 2022Article
- Review
- The efficacy of ketamine in total knee arthroplasty: a randomized controlled trial protocol.Medicine · 2020Article
- Acupuncture therapy for postoperative pain of anorectal diseases: A systematic review protocol.Medicine · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe local injection of multimodal cocktail is currently commonly used in the treatment of postoperative pain after total knee arthroplasty (TKA). It is still inconclusive whether the morphine added to the intraoperative injection mixture could make some difference. This meta-analysis aimed to evaluate the efficacy and safety of additional morphine injection on postoperative analgesia in TKA, and provide some useful information on morphine usage in clinical practice.
methodsThe randomized controlled trials (RCTs) in databases including PubMed, Web of Science, Embase, Cochrane Library, Chinese biomedical literature database (CBM), and Chinese National Knowledge Infrastructure (CNKI) databases were systematically searched. Of 623 records identified, 8 RCTs involving 1093 knees were eligible for data extraction and meta-analysis according to criteria included.
resultsMeta-analysis showed that the use of local morphine injection was not associated with significant pain relief within 48 hours postoperatively at rest and on motion (P > .05, all). The use of morphine reduced postoperative total systemic opioids consumption (P < .05). This study found no significant differences in other outcomes including knee flexion range of motion (ROM) (P > .05), extension ROM (P > .05), The Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores (P > .05), Post-operative nausea and vomiting occurrence (P > .05) regardless of the presence of morphine or not in the injections.
conclusionAdditional morphine added to multimodal cocktail did not decrease the postoperative pain scores significantly based on our outcomes, but it reduced the systemic postoperative opioids consumption in total knee arthroplasty.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.