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A meta-analysis evaluates the efficacy of intravenous acetaminophen for pain management in knee or hip arthroplasty.

Authors
  • Guo, Hongzhang1
  • Wang, Changde2
  • He, Yufang3
  • 1 Department of Orthopaedics, Gansu Provincial Hospital of TCM, 418# GuaZhou Road, Qi Li He Zone, Lanzhou, 730050, People's Republic of China. Electronic address: [email protected] , (China)
  • 2 Department of Orthopaedics, Gansu Provincial Hospital of TCM, 418# GuaZhou Road, Qi Li He Zone, Lanzhou, 730050, People's Republic of China. Electronic address: [email protected] , (China)
  • 3 The Third Hospital of Gansu Province, 736# Duan Jia Tan, Cheng Guan Zone, Lanzhou, 730030, People's Republic of China. Electronic address: [email protected] , (China)
Type
Published Article
Journal
Journal of Orthopaedic Science
Publisher
Elsevier
Publication Date
Sep 01, 2018
Volume
23
Issue
5
Pages
793–800
Identifiers
DOI: 10.1016/j.jos.2018.04.008
PMID: 29910098
Source
Medline
Language
English
License
Unknown

Abstract

The objective of this study was to assess whether intravenous acetaminophen for patients undergoing knee or hip arthroplasty could reduce the opioid consumption and improve pain management. Eligible studies were searched from electronic databases including PubMed, Web of Science, Embase (Ovid interface) and Cochrane Library (Ovid interface). The quality assessments were performed according to the Cochrane systematic review method. The assessed outcomes were including opioid consumption, pain scores, length of hospital stays and total occurrence of adverse events. Among 832 records identified, six randomized controlled trials (RCTs) and five non-RCTs were eligible for data extraction and meta-analysis. According to the outcomes, the patients receive intravenous acetaminophen had less total opioid consumption after knee or hip artroplasty (SMD = -0.66; 95%CI, -1.13 to -0.20), but they did not obtain statistical improvement of postoperative pain control at postoperative day 0 (POD0, SMD = -0,15; 95%CI, -0.36 to 0.07), POD1(SMD = 0,12; 95%CI, -0.13 to 0.36), POD2 (SMD = -0,29; 95%CI, -0.70 to 0.12) and POD3 (SMD = -0,04; 95%CI, -0.49 to 0.41). Meanwhile, there were similar outcomes about the length of hospital stays in patients whether or not receiving intravenous acetaminophen (SMD = -0,05; 95%CI, -0.26 to 0.15). And, the total adverse effects occurrence also didn't show any significant difference between the acetaminophen group and control group (OR = 0.87; 95%CI, 0.57 to 1.33). Perioperative intravenous acetaminophen use in multimodal analgesia could significantly reduce of total opioid consumption, but it did not contribute to decrease the average pain scores and shorten the length of hospital stays in total hip or knee arthroplasty. Copyright © 2018. Published by Elsevier B.V.

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