Intraarticular clonidine versus morphine for analgesia after arthroscopic knee surgery: A Meta-analysis

doi:10.3969/j.issn.2095-4344.2013.04.028

Abstract

Abstract:

BACKGROUND: Both intraarticular clonidine and morphine can provide analgesic effect, but the efficacy and safety of them are uncertain.
OBJECTIVE: To evaluate the efficacy and safety of intraarticular clonidine versus morphine for postoperativeanalgesia following arthroscopic knee surgery.
METHODS: PubMed database, EMBASE database, Cochrane Library, ISI Web of knowledge, CBM database, VIP database, CNKI database and Wanfang database were searched from their start year up to January 2012 for relevant randomized clinical trials on the intraarticular clonidine versus morphine for postoperative analgesia following arthroscopic knee surgery. Randomized clinical trials met the inclusion criteria were screened and included, and the quality was evaluated using seven-point Jadad scale and the data was analyzed using RevMan 5. 1.
RESULTS AND CONCLUSION: Four randomized clinical trials including 156 patients were included. The results of the Meta analysis showed: ①Visual analogue scale scores: there was no difference between intraarticular clonidine and morphine on the visual analogue scale scores at 1, 2, 4, 6, 12 and 24 hours after intraarticular; ②Effective analgesia: intraarticular clonidine could provide longer effective analgesia than morphine [mean difference (MD)=200.34, 95% confidence interval (CI)(177.67, 223.00), P < 0.01]; ③Rate of postoperative analgesic requirements: there was no significant difference of the rate of postoperative analgesic requirements between the two drugs relative risk (RR)=1.05, 95%CI(0.67, 1.65), P=0.83]; ④The incidence of side effects had no significant differences. The current evidence shows that there is no difference between intraarticular rejection of clonidine and morphine on the pain intensity and the rate of postoperative analgesic requirements, but intraarticular clonidine provides longer effective analgesia, and the incidence of side effects is similar. Yet more randomized clinical trials with large sample size are required to explore the question clearly.

Key words: bone and joint implants, evidence-based medicine of bone and joint implants, clonidine, morphine, intraarticular injection, analgesia, system evaluation, Meta-analysis

CLC Number:

R318

Sun Rao, Tian Hong-liang, Li Lun, Yang Ke-hu, Zhang Ze-qian, Li Xiu-xia. Intraarticular clonidine versus morphine for analgesia after arthroscopic knee surgery: A Meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(4): 750-754.

Figures/Tables 4

References

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