Efficacy of intra-articular ketorolac for pain control in arthroscopic surgeries: a systematic review and meta-analysis

Abstract Background The current systematic review and meta-analysis aimed to synthesize evidence on the efficacy of intra-articular ketorolac for patients undergoing arthroscopic surgeries. Methods PubMed, Embase, ScienceDirect, and Google Scholar databases were searched for randomized controlled tr...

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Autores principales:	Jingjing Yang, Bin Ni, Xiaoyan Fu
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Arthroscopy Knee joint Shoulder joint Pain NSAIDs Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/a35259aa83cf4cca9f0b6d6a382584aa
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spelling	oai:doaj.org-article:a35259aa83cf4cca9f0b6d6a382584aa2021-11-28T12:27:06ZEfficacy of intra-articular ketorolac for pain control in arthroscopic surgeries: a systematic review and meta-analysis10.1186/s13018-021-02833-41749-799Xhttps://doaj.org/article/a35259aa83cf4cca9f0b6d6a382584aa2021-11-01T00:00:00Zhttps://doi.org/10.1186/s13018-021-02833-4https://doaj.org/toc/1749-799XAbstract Background The current systematic review and meta-analysis aimed to synthesize evidence on the efficacy of intra-articular ketorolac for patients undergoing arthroscopic surgeries. Methods PubMed, Embase, ScienceDirect, and Google Scholar databases were searched for randomized controlled trials assessing the analgesic effect of intra-articular ketorolac for arthroscopic surgery of hip/knee or shoulder joint. Results Six studies were included. Two studies were on shoulder arthroscopy, while others were on knee joint. Meta-analysis revealed that patients receiving intra-articular ketorolac had significantly lower pain scores at 2–4 h (MD: − 0.58 95% CI: − 0.88, − 0.19 I 2 = 49% p = 0.002), 6–8 h (MD: − 0.77 95% CI: − 1.11, − 0.44 I 2 = 31% p < 0.00001), 12 h (MD: − 0.94 95% CI: − 1.21, − 0.67 I 2 = 0% p < 0.00001), and 24 h (MD: − 1.28 95% CI: − 1.85, − 0.71 I 2 = 84% p < 0.00001) as compared to the control group (Certainty of evidence: low-moderate). Analysis of three studies revealed a tendency of reduced analgesic consumption in patients receiving intra-articular ketorolac, but the difference did not reach statistical significance (MD: − 0.53 95% CI: − 1.07, 0.02 I 2 = 55% p = 0.06). Conclusions Preliminary evidence from a limited number of studies indicates that additional intra-articular ketorolac to multimodal analgesia results in reduced pain scores up to 24 h after arthroscopic surgery. The clinical relevance of small changes in pain scores is debatable. Also, scarce data suggest that consumption of analgesics may not be reduced with intra-articular ketorolac. Since pain scores can be influenced by the primary diagnosis and dose of ketorolac, the results should be interpreted with caution. The certainty of the evidence is low-moderate. There is a need for future RCTs to further strengthen current evidence.Jingjing YangBin NiXiaoyan FuBMCarticleArthroscopyKnee jointShoulder jointPainNSAIDsOrthopedic surgeryRD701-811Diseases of the musculoskeletal systemRC925-935ENJournal of Orthopaedic Surgery and Research, Vol 16, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arthroscopy Knee joint Shoulder joint Pain NSAIDs Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935
spellingShingle	Arthroscopy Knee joint Shoulder joint Pain NSAIDs Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935 Jingjing Yang Bin Ni Xiaoyan Fu Efficacy of intra-articular ketorolac for pain control in arthroscopic surgeries: a systematic review and meta-analysis
description	Abstract Background The current systematic review and meta-analysis aimed to synthesize evidence on the efficacy of intra-articular ketorolac for patients undergoing arthroscopic surgeries. Methods PubMed, Embase, ScienceDirect, and Google Scholar databases were searched for randomized controlled trials assessing the analgesic effect of intra-articular ketorolac for arthroscopic surgery of hip/knee or shoulder joint. Results Six studies were included. Two studies were on shoulder arthroscopy, while others were on knee joint. Meta-analysis revealed that patients receiving intra-articular ketorolac had significantly lower pain scores at 2–4 h (MD: − 0.58 95% CI: − 0.88, − 0.19 I 2 = 49% p = 0.002), 6–8 h (MD: − 0.77 95% CI: − 1.11, − 0.44 I 2 = 31% p < 0.00001), 12 h (MD: − 0.94 95% CI: − 1.21, − 0.67 I 2 = 0% p < 0.00001), and 24 h (MD: − 1.28 95% CI: − 1.85, − 0.71 I 2 = 84% p < 0.00001) as compared to the control group (Certainty of evidence: low-moderate). Analysis of three studies revealed a tendency of reduced analgesic consumption in patients receiving intra-articular ketorolac, but the difference did not reach statistical significance (MD: − 0.53 95% CI: − 1.07, 0.02 I 2 = 55% p = 0.06). Conclusions Preliminary evidence from a limited number of studies indicates that additional intra-articular ketorolac to multimodal analgesia results in reduced pain scores up to 24 h after arthroscopic surgery. The clinical relevance of small changes in pain scores is debatable. Also, scarce data suggest that consumption of analgesics may not be reduced with intra-articular ketorolac. Since pain scores can be influenced by the primary diagnosis and dose of ketorolac, the results should be interpreted with caution. The certainty of the evidence is low-moderate. There is a need for future RCTs to further strengthen current evidence.
format	article
author	Jingjing Yang Bin Ni Xiaoyan Fu
author_facet	Jingjing Yang Bin Ni Xiaoyan Fu
author_sort	Jingjing Yang
title	Efficacy of intra-articular ketorolac for pain control in arthroscopic surgeries: a systematic review and meta-analysis
title_short	Efficacy of intra-articular ketorolac for pain control in arthroscopic surgeries: a systematic review and meta-analysis
title_full	Efficacy of intra-articular ketorolac for pain control in arthroscopic surgeries: a systematic review and meta-analysis
title_fullStr	Efficacy of intra-articular ketorolac for pain control in arthroscopic surgeries: a systematic review and meta-analysis
title_full_unstemmed	Efficacy of intra-articular ketorolac for pain control in arthroscopic surgeries: a systematic review and meta-analysis
title_sort	efficacy of intra-articular ketorolac for pain control in arthroscopic surgeries: a systematic review and meta-analysis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/a35259aa83cf4cca9f0b6d6a382584aa
work_keys_str_mv	AT jingjingyang efficacyofintraarticularketorolacforpaincontrolinarthroscopicsurgeriesasystematicreviewandmetaanalysis AT binni efficacyofintraarticularketorolacforpaincontrolinarthroscopicsurgeriesasystematicreviewandmetaanalysis AT xiaoyanfu efficacyofintraarticularketorolacforpaincontrolinarthroscopicsurgeriesasystematicreviewandmetaanalysis
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Efficacy of intra-articular ketorolac for pain control in arthroscopic surgeries: a systematic review and meta-analysis

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