Evidence map›Paper›PMID 39702868›Full record

SynthesisDrugs2025

Effectiveness of Interventions to Reduce Opioid Use After Orthopaedic Surgery: A Systematic Review of Randomised Controlled Trials.

Melanie Hamilton, Stephanie Mathieson, Masoud Jamshidi, Andy Wang, Yi-Ching Lee, Danijela Gnjidic, Chung-Wei Christine Lin

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Drugs, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
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

7 authors.

Melanie HamiltonFaculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Sydney Musculoskeletal Health, Sydney, Australia. melanie.hamilton@sydney.edu.au.ORCID http://orcid.org/0000-0002-9337-943X
Stephanie MathiesonFaculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney Musculoskeletal Health, Kolling Institute, Sydney, Australia.ORCID http://orcid.org/0000-0002-7335-8842
Masoud JamshidiFaculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Sydney Musculoskeletal Health, Sydney, Australia.
Andy WangFaculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, Australia.
Yi-Ching LeeFaculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, Australia.
Danijela GnjidicFaculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, Australia.ORCID http://orcid.org/0000-0002-9404-3401
Chung-Wei Christine LinFaculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Sydney Musculoskeletal Health, Sydney, Australia.ORCID http://orcid.org/0000-0001-6192-7238

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe prescribing of opioids to patients for postoperative pain can lead to persistent opioid use. This review investigated the effectiveness of interventions aimed at reducing opioid use in patients after orthopaedic surgery.

methodsElectronic databases were searched from inception to November 2023. We included randomised controlled trials investigating interventions aimed at reducing opioid use after orthopaedic surgery. Two reviewers conducted the screening and data extraction and assessed the risk of bias (Cochrane Risk of Bias tool) and certainty of evidence (GRADE). The primary outcome was the mean daily dose of opioid analgesic medications in the medium term (1-3 months after randomisation). Results were pooled in a meta-analysis using a random-effects model where appropriate (e.g. I

resultsThe search yielded 17,471 records, of which 39 trials were included. High heterogeneity meant that most comparisons could not be pooled. The mean daily dose was lower with multimodal analgesia interventions than with placebo/no intervention/usual care or active control in the medium term. No between-group differences were found between other pharmacological or non-pharmacological interventions and either placebo/no intervention/usual care or active control at the medium-term time point. The certainty of evidence ranged from low to moderate.

conclusionsMultimodal analgesic interventions may reduce opioid use compared with placebo/no intervention/usual care or active control in the medium term. However, the high heterogeneity and low certainty of evidence means it is uncertain which interventions are effective in reducing opioid use after orthopaedic surgery.

Indexed as

Analgesics, OpioidOpioid-Related DisordersOrthopedic ProceduresPostoperative PainHumansRandomized Controlled Trials as TopicAnalgesics, Opioid

Identifiers

PMID39702868
PMCPMC11891105

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.