Tramadol as an adjunct to intra-articular local anaesthetic infiltration in knee arthroscopy: a systematic review and meta-analysis.


Journal

ANZ journal of surgery
ISSN: 1445-2197
Titre abrégé: ANZ J Surg
Pays: Australia
ID NLM: 101086634

Informations de publication

Date de publication:
07 2019
Historique:
received: 06 04 2018
revised: 11 09 2018
accepted: 14 09 2018
pubmed: 27 1 2019
medline: 7 8 2020
entrez: 27 1 2019
Statut: ppublish

Résumé

Arthroscopic knee surgery is a common technique used in Australia. Post-operative pain is common and can lead to delayed discharge and impair early mobilization. Use of local anaesthesia can reduce pain while avoiding systemic side effects. This systematic review and meta-analysis aimed to establish the use of tramadol as an adjunct to intra-articular local anaesthetic infiltration in knee arthroscopy in the current literature. Two independent reviewers performed a systematic search of four databases, where 24 articles were identified with six studies (four high-quality and two low-quality randomized controlled trials), with a total of 334 patients were included for analysis. RevMan 5.3 software (The Nordic Cochrane Centre, Copenhagen, Denmark) was used to perform the data analysis. The studies included focused on outcomes such as pain scores, breakthrough analgesia, total analgesia, time to discharge and adverse events related to the use of tramadol as an adjunctive therapy. This study found that using tramadol as an adjunct to intra-articular local anaesthetic infiltration in arthroscopic knee surgery reduced post-operative pain and increased time to breakthrough analgesia without an increase in side effects. This meta-analysis suggests that tramadol is an efficacious adjunct for use in intra-articular local anaesthetic infiltration following arthroscopic knee surgery.

Sections du résumé

BACKGROUND
Arthroscopic knee surgery is a common technique used in Australia. Post-operative pain is common and can lead to delayed discharge and impair early mobilization. Use of local anaesthesia can reduce pain while avoiding systemic side effects. This systematic review and meta-analysis aimed to establish the use of tramadol as an adjunct to intra-articular local anaesthetic infiltration in knee arthroscopy in the current literature.
METHODS
Two independent reviewers performed a systematic search of four databases, where 24 articles were identified with six studies (four high-quality and two low-quality randomized controlled trials), with a total of 334 patients were included for analysis. RevMan 5.3 software (The Nordic Cochrane Centre, Copenhagen, Denmark) was used to perform the data analysis. The studies included focused on outcomes such as pain scores, breakthrough analgesia, total analgesia, time to discharge and adverse events related to the use of tramadol as an adjunctive therapy.
RESULTS
This study found that using tramadol as an adjunct to intra-articular local anaesthetic infiltration in arthroscopic knee surgery reduced post-operative pain and increased time to breakthrough analgesia without an increase in side effects.
CONCLUSION
This meta-analysis suggests that tramadol is an efficacious adjunct for use in intra-articular local anaesthetic infiltration following arthroscopic knee surgery.

Identifiants

pubmed: 30684306
doi: 10.1111/ans.14920
doi:

Substances chimiques

Analgesics, Opioid 0
Anesthetics, Local 0
Tramadol 39J1LGJ30J

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

827-832

Informations de copyright

© 2019 Royal Australasian College of Surgeons.

Auteurs

Thomas Ryan (T)

Department of Orthopaedics, John Hunter Hospital, Newcastle, New South Wales, Australia.
School of Medicine Sydney, Wagga Wagga Rural Clinical School, The University of Notre Dame Australia, Wagga Wagga, New South Wales, Australia.

Anthony Hodge (A)

Department of Medicine, The University of Queensland, Brisbane, Queensland, Australia.

Rhys Holyoak (R)

School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia.

Ruan Vlok (R)

School of Medicine Sydney, Wagga Wagga Rural Clinical School, The University of Notre Dame Australia, Wagga Wagga, New South Wales, Australia.
Department of Medicine, Wagga Wagga Rural Referral Hospital, Wagga Wagga, New South Wales, Australia.

Thomas Melhuish (T)

Department of Medicine, Wagga Wagga Rural Referral Hospital, Wagga Wagga, New South Wales, Australia.
Department of Medicine, The University of New South Wales, Sydney, New South Wales, Australia.

Matthew Binks (M)

Department of Medicine, Wagga Wagga Rural Referral Hospital, Wagga Wagga, New South Wales, Australia.
Department of Medicine, The University of New South Wales, Sydney, New South Wales, Australia.

Glenn Hurtado (G)

Department of Medicine, Caboolture Hospital, Caboolture, Queensland, Australia.

Leigh White (L)

School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia.
Department of Medicine, Caboolture Hospital, Caboolture, Queensland, Australia.

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Classifications MeSH