Evidence map›Paper›PMID 39666052›Full record

Trial reportArchives of orthopaedic and trauma surgery2024

Efficacy of preemptive multimodal analgesia initiated at various time points before total knee arthroplasty: a prospective, double-blind randomized controlled trial.

Qiuru Wang, Xingcheng Li, Jian Hu, Changjun Chen, Jing Yang, Pengde Kang

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
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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.

Qiuru Wang *Department of Orthopedic Surgery, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu, Sichuan, 610041, People's Republic of China.
Xingcheng Li *Department of Nephrology, West China Tianfu Hospital, West China School of Nursing, Sichuan University, No. 3966 Tianfu Avenue, Chengdu, 610200, China.
Jian HuDepartment of Anesthesiology, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu, Sichuan, 610041, People's Republic of China.
Changjun ChenDepartment of Orthopedic Surgery, The First Affiliated Hospital of Shandong First Medical, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, University and Shandong Provincial Qianfoshan Hospital, Jinan, 250000, China.
Jing YangDepartment of Anesthesiology, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu, Sichuan, 610041, People's Republic of China. hxyangjing@qq.com.
Pengde KangDepartment of Orthopedic Surgery, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu, Sichuan, 610041, People's Republic of China. kangpd@163.com.ORCID http://orcid.org/0000-0003-3710-0796

Funding

West China Hospital, Sichuan University ZYJC18040
6 · The paper itself

Abstract

introductionPreemptive multimodal analgesia (PMA) is commonly employed for pain control after total knee arthroplasty (TKA). However, the optimal timing for initiating PMA remains unclear. This study aimed to compare the efficacy of PMA administered at different time points before TKA. MATERIALS AND

methodsIn this prospective, double-blind, placebo-controlled, randomized trial, 120 patients who underwent TKA were randomized into three groups. PMA (200 mg celecoxib and 150 mg pregabalin administered every 12 h) was initiated 48 h (group A), 24 h (group B), and 1 h (group C) before surgery. The primary outcome was the postoperative administration of morphine hydrochloride as a rescue analgesic. Secondary outcomes included time to first rescue analgesia, postoperative pain assessed using the visual analog scale (VAS), functional recovery assessed by knee motion range and ambulation distance, time until hospital discharge, and complication rates.

resultsCompared with group C, groups A and B exhibited significantly lower morphine consumption within 24 h after surgery, lower total morphine consumption, longer time to first rescue analgesia, and superior range of knee motion on the day of surgery. Groups A and B did not exhibit significant differences in these outcomes. The three groups did not differ significantly in postoperative VAS pain scores, ambulation distance, length of hospital stay, or complication rates.

conclusionsIn comparison with PMA starting at 1 h preoperatively, initiating PMA at 24 and 48 h preoperatively provided better postoperative pain relief. Considering the aim of minimizing the amount of ineffective medication received by patients, initiating PMA at 24 h preoperatively may be a more favorable option for patients undergoing TKA. However, the clinical significance of our results and the optimal starting time for PMA require further investigation.

Indexed as

Arthroplasty, Replacement, KneeCelecoxibPostoperative PainAgedAnalgesiaAnalgesicsAnalgesics, OpioidDouble-Blind MethodFemaleHumansMaleMiddle AgedMorphinePain ManagementPain MeasurementPregabalinAnalgesicsAnalgesics, OpioidCelecoxibMorphinePregabalinMultimodal analgesiaOpioidsPainPreemptive analgesiaTotal knee arthroplasty

Identifiers

PMID39666052

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Registered trials

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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.