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07.06.2015 | Knee | Ausgabe 5/2016

Knee Surgery, Sports Traumatology, Arthroscopy 5/2016

Single-dose intra-articular ropivacaine after arthroscopic knee surgery decreases post-operative pain without increasing side effects: a systematic review and meta-analysis

Zeitschrift:
Knee Surgery, Sports Traumatology, Arthroscopy > Ausgabe 5/2016
Autoren:
Yang Zhou, Tu-bao Yang, Jie Wei, Chao Zeng, Hui li, Tuo Yang, Guang-hua Lei

Abstract

Purpose

The purpose of this study was to appraise the efficacy and safety of single-dose intra-articular ropivacaine administered for pain relief after arthroscopic knee surgery.

Methods

PubMed, Embase, and Cochrane Library databases were searched in October 2014 to identify randomized controlled trials of single-dose intra-articular ropivacaine for post-operative pain relief. Post-operative pain intensity, the amount of rescue analgesia required, and side effects including local anaesthetic toxicity were assessed. The relative risk (RR), the weighted mean difference (WMD), and their corresponding 95 % confidence intervals (CIs) were calculated.

Results

Eight randomized controlled trials were included in the analysis. Statistically significant differences in the visual analogue scale for pain intensity value were observed during the immediate post-operative period (WMD −10.35, 95 % CI −17.12 to −3.59, p = 0.003) and the early post-operative period (WMD −11.90, 95 % CI −18.12 to −5.69, p = 0.0002), but not during the late post-operative period (WMD −2.89, 95 % CI −7.46 to 1.68, n.s.). There was no significant difference in the amount of rescue analgesia required (RR 0.76, 95 % CI 0.52–1.11, n.s.). Only two trials reported the incidence of drug-related side effects (including nausea and vomiting): the incidence in the ropivacaine groups was no higher than that in the control groups. Only one trial assessed local anaesthetic toxicity as an outcome, but it was not detected.

Conclusions

Single-dose intra-articular ropivacaine administered at the end of arthroscopic knee surgery provides effective pain relief in the immediate and early post-operative periods without increasing short-term side effects.

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