METHODS: Systematic review and meta-analysis.
METHODS: Comparative studies that compared PAI and IAI in patients after TKA were searched in the Embase, PubMed, MEDLINE, and the Cochrane Library databases. The primary outcomes were visual analog scale scores for pain and opioid consumption. The secondary outcomes were complications, function of recovery, and length of hospital stay.
RESULTS: Four randomized controlled trials and two case-controlled studies with a total of 769 patients were enrolled. There were no significant differences in mean visual analog scale scores at postoperative day 0 (P = .17) and day 1 (P = .27), maximum visual analog scale scores at day 0 (P = .89) and day 1 (P = .82), total opioid consumption at day 1 (P = .96), opioid complications (P = .15), and length of hospital stay (P = .84) between PAI and IAI.
CONCLUSIONS: Based on the available evidence, PAI does not offer superior effects at pain control and discharge than IAI after TKA. However, owing to the limited sample size and heterogeneity of the included studies, further large well-designed randomized controlled trials are still needed to validate this conclusion.
UNASSIGNED: The protocol has been registered in the PROSPERO international database under number CRD42020165138.
方法:系统评价和荟萃分析。
方法:在Embase中搜索比较TKA术后患者PAI和IAI的比较研究,PubMed,MEDLINE,和Cochrane图书馆数据库.主要结果是疼痛和阿片类药物消耗的视觉模拟量表评分。次要结果是并发症,恢复功能,和住院时间。
结果:纳入4项随机对照试验和2项病例对照研究,共769例患者。术后第0天(P=0.17)和第1天(P=0.27)的平均视觉模拟量表评分没有显着差异,第0天(P=0.89)和第1天(P=0.82)的最大视觉模拟量表得分,第1天的阿片类药物总消费量(P=0.96),阿片类并发症(P=0.15),PAI和IAI之间的住院时间(P=0.84)。
结论:根据现有证据,在TKA后,PAI在疼痛控制和出院方面的效果不如IAI。然而,由于纳入研究的样本量有限和异质性,仍需要进一步的大型精心设计的随机对照试验来验证这一结论.
■该协议已在PROSPERO国际数据库中注册,编号为CRD42020165138。