Preoperative Nonopioid Analgesia Reduces Postoperative Opioid Consumption After Arthroscopic Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Abstract
Background: Orthopaedic surgeons frequently overprescribe opioids after arthroscopic surgery. Previous research has shown reductions in postoperative opioid consumption and pain scores with multimodal nonopioid analgesics. However, the clinical effect of preoperative analgesic strategies has not been fully uncovered.
Purpose: To assess the outcomes of arthroscopic surgery associated with preoperative treatment with nonopioid medications.
Study design: Systematic review and meta-analysis; Level of evidence, 1.
Methods: Three online databases (PubMed, MEDLINE, Embase) were searched on December 12, 2024, to identify randomized controlled trials investigating the effect of preoperative intervention on pain management following arthroscopic surgery. Extracted data included patient demographics, surgery type, analgesic protocols (ie, type, dosing, timing), adverse effects, postoperative opioid consumption, and pain scores. Postoperative opioid consumption was standardized and converted to oral morphine equivalents. Pain scores were assessed using the visual analog scale (VAS). Weighted means and meta-analyses were conducted to compare postoperative outcomes. Subgroup analyses were performed by analgesic class (COX-2 inhibitors, gabapentin) and surgery type. The quality of studies was assessed with the Risk of Bias 2 tool.
Results: A total of 22 studies were included in this review. The overall pooled mean reduction in postoperative opioid consumption with any preoperative…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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