Effectiveness of Intravenous Non-Opioid Analgesics for Postoperative Pain Management of in Patients Undergoing Hip Surgery: A Systematic Review and Meta-Analysis

Medicina (Kaunas). 2023 Oct 27;59(11):1904. doi: 10.3390/medicina59111904.

Abstract

Background and Objectives: Intravenous (IV) non-opioid analgesics (NOAs) have been extensively investigated as a multimodal analgesic strategy for the management of acute pain after hip surgery. This pair-wise meta-analysis examined IV NOA effects following hip surgery. Materials and Methods: A systematic search of the MEDLINE (PUBMED), Embase, and Cochrane Library databases was performed for studies investigating the effect of IV NOA for postoperative pain management following hip surgery up to 7 June 2023. We compared in-admission opioid use, postoperative VAS (visual analogue scale) score, hospital stay duration, and opioid-related adverse events between IV NOA and control groups. Results: Seven studies were included with a total of 953 patients who underwent hip surgery. Of these, 478 underwent IV NOA treatment, and 475 did not. The IV NOA groups had lower opioid use within 24-h following hip surgery (SMD, -0.48; 95% CI, -0.66 to -0.30; p < 0.01), lower VAS score (SMD, -0.47; 95% CI, -0.79 to -0.16; p < 0.01), shorter hospital stay (SMD, -0.28; 95% CI, -0.44 to -0.12; p < 0.01), and lower incidence of nausea and vomiting (OR, 0.32; 95% CI, 0.15 to 0.67; p < 0.01) compared with the control groups. Conclusions: This meta-analysis demonstrated that IV NOA administration following hip surgery may have more favorable postoperative outcomes than those in control groups.

Keywords: NSAIDs; acetaminophen; hip surgery; intravenous; non-opioid analgesics.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Administration, Intravenous
  • Analgesics / therapeutic use
  • Analgesics, Non-Narcotic* / therapeutic use
  • Analgesics, Opioid / therapeutic use
  • Humans
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / etiology

Substances

  • Analgesics, Non-Narcotic
  • Analgesics, Opioid
  • Analgesics

Grants and funding

This work was supported by the Korea Evaluation Institute of Industrial Technology grant funded by the Ministry of Trade, Industry, and Energy (MOTIE, Korea) (No. 20016543, Development of a titanium alloy wire rod with a roundness of 50 µm or less for biomedical and dental/orthopedic implant application technology).