Total knee arthroplasty (TKA) is associated with considerable postoperative pain. The relative analgesic efficacy and adverse effect profile of perioperative use of selective cyclooxygenase-2 (COX-2) inhibitors for patients undergoing TKA are unclear. This is a systematic review and meta-analysis of all randomized controlled trials evaluating perioperative administration of COX-2 inhibitors for TKA. Eight studies that had enrolled a total of 571 patients were identified. There was a statistical significance in postoperative pain scores (0-24 hours: P = .0007, 24-48 hours: P = .01, 48-72 hours: P < .0001), opioid consumption (P = .006), active range of motion (P = .002), itching (P = .005), and postoperative nausea/vomiting (P = .003) between groups. There was no difference in blood loss during the first 24 hours after operation between groups. The efficacy of perioperative administration of selective COX-2 inhibitors to reduce postoperative pain and opioid consumption after TKA is validated. Furthermore, it has important outcome benefits after TKA.
The Journal of Arthroplasty, Volume 28, Issue 2, 207 - 213.e2
Perioperative Administration of Selective Cyclooxygenase-2 Inhibitors for Postoperative Pain Management in Patients After Total Knee ArthroplastyLin, Jun et al.