Transdermal fentanyl patch provides better pain relief and faster functional recovery after total knee arthroplasty:a meta-analysis

Abstract

Background : Pain after total knee arthroplasty (TKA) was severe and should be effectively managed. This meta-analysis aimed to compare transdermal fentanyl patch (TFP) versus placebo for pain control after TKA. Methods : PubMed, Embase, Cochrane library and Chinese National Knowledge Infrastructure (CNKI) were electronically searched. Potential clinical studies that investigated the effect and safety of TFP versus control in TKA patients were searched. The primary outcomes were total morphine consumption. Stata 12.0 was used for meta-analysis. Results : Four randomized controlled trials (RCTs) involving 110 TKA patients were included in this meta-analysis. Compared with control group, TFP was associated with a reduction of total morphine consumption (WMD: -16.14; 95% CI: -25.82 to -6.46; P=0.001). Moreover, TFP could significantly reduce VAS at 2 h, 4 h, 6 h, 12 h, 24 h, 48 h and 72 h (P<0.05). There was no statistically significance between the nausea, vomiting, hypertension, sweating, respiratory depression, pruritus and urine retention (P>0.05). Conclusion : The present meta-analysis showed that use of TFP for the management of moderate or severe TKA postoperative pain had more advantages compared to placebo. Further large-scale, prospective RCTs are required to verify the effect of TFP and optimal dose of TFP in TKA patients.