Imrecoxib versus celecoxib as postoperative analgesia for patients receiving arthroscopic knee surgery: a randomized, controlled, non-inferiority study

Guo, Wei; Liu, Ying; Li, Jingjing

doi:10.1007/s10787-022-00938-8

Cited by 5 publications

(10 citation statements)

References 23 publications

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“…One study compared 2 different NSAIDs (imrecoxib and celecoxib) in patients undergoing knee arthroscopy. That study found that imrecoxib was noninferior to celecoxib for alleviating pain or in opioid medication use and adverse events 11 .…”

Section: Results Of Individual Studies Oral Medicationsmentioning

confidence: 97%

“…Zolpidem, which was analyzed in 2 studies to help manage pain and improve sleep, was effective, compared with control, in reducing pain scores and opioid consumption 30 . Similarly, imrecoxib is a relatively novel cyclooxygenase-2 selective NSAID, which was found to be noninferior to celecoxib in one study 11 . These medications may represent further nonopioid options in the toolbox to manage postoperative pain, but given their relative novelty for this indication, patients must be counselled thoroughly on their use.…”

Section: Discussionmentioning

confidence: 98%

“…Fifteen studies (71.4%) analyzed the efficacy of oral analgesic medications, including nonsteroidal antiinflammatory drugs (NSAIDs), acetaminophen, and zolpidem, at managing perioperative pain [10][11][12][13][19][20][21]24,26,[28][29][30][31][32][33] . Four studies (19.0%) assessed local pain management modalities, such as transcutaneous electrical nerve stimulation (TENS), cryotherapy, or bandaging 18,22,25,34 .…”

Section: Study Characteristicsmentioning

confidence: 99%

“…After removal of duplicates, 1,785 unique studies underwent title/ abstract screening, with 63 undergoing full-text screening. Ultimately, 21 studies were included in final data extraction and analysis [10][11][12][13][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] . Figure 1 shows the number of studies at each step of the screening process.…”

Section: Study Selectionmentioning

confidence: 99%

“…Most of orthopaedic surgeons performing arthroscopy agree that opioid overprescription is an issue within the subspecialty 9 . As well, recent highquality studies have evaluated a variety of interventions aimed at reducing opioid prescription and consumption after orthopaedic surgery [10][11][12][13] . Thus, the purpose of this study was to review and synthesize the available evidence from randomized controlled trials (RCTs) on interventions aimed at reducing opioid use after arthroscopic surgery to provide practical and evidence-based information for the care of arthroscopy patients.…”

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confidence: 99%

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Opioid-Sparing Strategies in Arthroscopic Surgery

et al. 2023

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Background: Opioid overprescription is a problem in orthopaedic surgery. Arthroscopic surgery, given its minimally invasive nature, represents an opportunity to minimize opioid prescription and consumption by using effective pain management adjuncts. Thus, the primary question posed in this study was which noninvasive pain management modalities can effectively manage pain and reduce opioid intake after arthroscopic surgery. Methods: The databases PubMed, MEDLINE, EMBASE, Scopus, and Web of Science were searched on August 10, 2022. Randomized controlled trials (RCTs) evaluating noninvasive pain management strategies in arthroscopy patients were evaluated. Eligible studies were selected through a systematic screening process. Meta-analysis was performed for pain scores and opioid consumption at time points which had sufficient data available. Results: Twenty-one RCTs were included, with a total of 2,148 patients undergoing shoulder, knee, and hip arthroscopy. Meta-analysis comparing nonopioid, oral analgesic regimens, with or without patient education components, with the standard of care or placebo demonstrated no difference in pain scores at 24 hours, 4 to 7 days, or 14 days postoperatively. Nonopioid regimens also resulted in significantly lower opioid consumption in the first 24 hours postoperatively (mean difference, −37.02 mg oral morphine equivalents, 95% confidence interval, −74.01 to −0.03). Transcutaneous electrical nerve stimulation (TENS), cryotherapy, and zolpidem were also found to effectively manage pain and reduce opioid use in a limited number of studies. Conclusions: A range of noninvasive pain management strategies exist to manage pain and reduce opioid use after arthroscopic procedures. The strongest evidence base supports the use of multimodal nonopioid oral analgesics, with some studies incorporating patient education components. Some evidence supports the efficacy of TENS, cryotherapy, and nonbenzodiazepine sleeping aids. Direction from governing bodies is an important next step to incorporate these adjuncts into routine clinical practice to manage pain and reduce the amount of opioids prescribed and consumed after arthroscopic surgery. Level of Evidence: Level II, systematic review and meta-analysis of RCTs. See Instructions for Authors for a complete description of the levels of evidence.

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Section: Results Of Individual Studies Oral Medicationsmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 98%