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COX-2 inhibitors improve pain, outcome scores after TKA
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Perioperative administration of cyclooxygenase-2 inhibitors eases postoperative pain and improves outcomes after total knee arthroplasty, according to systematic review of 571 patients.
“The principal finding of this systematic review showed that the perioperative administration of selective cyclooxygenase-2 inhibitors led to lower postoperative visual analog scale pain scores and effective joint range of motion in the operated knee, in addition to reducing postoperative opioid consumption and opioid-related adverse effects in the immediate postoperative period,” Jun Lin, MD, PhD, and colleagues wrote in their study.
Lin and colleagues searched the MEDLINE, EMBASE, PubMed and CINAHL databases and the Bandolier and the Cochrane Controlled Trials Register for total knee arthroplasty (TKA) results, ultimately using eight studies in their analysis. Patients received refecoxib in three studies and celecoxib in five studies.
In eight studies, pain reached statistical significance 72 hours after total kneee arthoplasty (TKA). Active range of motion was statistically significant between groups 3 days after TKA in seven studies. The researchers found significant associations in opioid consumption between experimental and control groups in six studies.
Additionally, nausea and vomiting occurred less frequently postoperatively if patients received a COX-2 inhibitor both before and after surgery. There was no difference in blood loss within the first 24 hours after surgery in either group.
Disclosure: Lin has no relevant financial disclosures.
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