Evidence map›Paper›PMID 32889557›Full record

SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2021

Perioperative nonopioid analgesia reduces postoperative opioid consumption in knee arthroscopy: a systematic review and meta-analysis.

Aaron Gazendam, Seper Ekhtiari, Nolan S Horner, Nicholas Nucci, Jared Dookie, Olufemi R Ayeni

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.

  1. Pooled it
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  10. Comprehensive Analysis of Opioid Use After Common Elective Outpatient Orthopaedic Surgeries.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2022
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Aaron GazendamDivision of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada. aaron.gazendam@gmail.com.ORCID http://orcid.org/0000-0002-2615-4919
Seper EkhtiariDivision of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Nolan S HornerDivision of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Nicholas NucciNorthern Ontario School of Medicine, Thunder Bay, ON, Canada.
Jared DookieSchulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Olufemi R AyeniDivision of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
McMaster University · CANOSM University · CAWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe opioid epidemic has prompted an emphasis on investigating opioid-sparing alternatives for pain management following knee arthroscopy. This review evaluated the effects of perioperative nonopioid adjunct analgesia on postoperative opioid consumption and pain control in patients undergoing knee arthroscopy.

methodsA systematic review and meta-analysis was performed using the following databases: PubMed, Embase, Web of Science, MEDLINE, and SCOPUS. Prospective comparative studies assessing the efficacy of various perioperative nonopioid analgesic strategies in patients undergoing knee arthroscopy were included. Twenty-five studies (n = 2408) were included.

resultsPre-emptive nonopioid pain medications demonstrated a reduction in cumulative postoperative oral morphine equivalent (OME) consumption by 11.8 mg (95% CI - 18.3, - 5.4, p ≤ 0.0001) and VAS pain scores by 1.5 (95% CI - 2.3, - 0.7, p < 0.001) at 24 h compared to placebo. Postoperative nonopioid pain medications significantly reduced cumulative postoperative OME consumption by 9.7 mg (95% CI - 14.4, - 5.1, p < 0.001) and VAS pain scores by 1.0 (95% CI - 1.354, - 0.633, p < 0.001) at 24 h compared to placebo. Saphenous nerve blocks significantly reduced cumulative postoperative OME consumption by 6.5 mg (95% CI - 10.3, - 2.6, p = 0.01) and VAS pain scores by 0.8 (- 1.4, - 0.3, p = 0.03) at 24 h compared to placebo. Both preoperative patient education and postoperative cryotherapy reduced postoperative opioid consumption.

conclusionPerioperative nonopioid pharmacotherapy, saphenous nerve blocks, and cryotherapy for patients undergoing knee arthroscopy significantly reduce opioid consumption and pain scores when compared to placebo at 24 h postoperatively. These interventions should be considered in efforts to reduce opioid consumption in patients undergoing knee arthroscopy. More research is needed to determine which interventions can reduce pain outside of the immediate postoperative period and the potential synergistic effects of combining interventions. LEVEL OF EVIDENCE: II.

Indexed as

Perioperative CareAnalgesics, Non-NarcoticAnalgesics, OpioidArthroscopyCryotherapyHumansKnee JointMorphineNerve BlockPain MeasurementPatient Education as TopicPostoperative PainProspective StudiesAnalgesics, Non-NarcoticAnalgesics, OpioidMorphineKnee arthroscopyMeta-analysisOpioid sparingPain management

Identifiers

PMID32889557
OpenAlexW3083760082

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.