Data from: Single-dose intra-articular bupivacaine plus morphine after knee arthroscopic surgery: a meta-analysis of randomized placebo-controlled studies

Objectives: To evaluate the efficacy and safety of single-dose intra-articular bupivacaine plus morphine after knee arthroscopic surgery. Design: Meta-analysis. Data sources and study eligibility criteria: A comprehensive literature search, using Medline (1966–2014), the Cochrane Central Register of Controlled Trials and Embase databases, was conducted to identify randomised placebo-controlled trials that used a combination of single-dose intra-articular bupivacaine and morphine for postoperative pain relief. Results: 12 articles were included in this meta-analysis. The mean visual analogue scale (VAS) scores of the bupivacaine plus morphine group were significantly lower than those of the placebo group (weighted mean difference (WMD) −1.75; 95% CI −2.16 to −1.33; p<0.001). The VAS scores at the last follow-up time point (last VAS scores) of the bupivacaine plus morphine group were also significantly lower than those of the placebo group (WMD −1.46; 95% CI −1.63 to −1.29; p<0.001). The number of patients requiring supplementary analgesia was also significantly reduced (RR 0.60; 95% CI 0.39 to 0.93; p=0.02), while there was no significant difference in the time to first analgesic request (WMD 3.46; 95% CI −1.81 to 8.72; p=0.20) or short-term side effects (RR 1.67; 95% CI 0.65 to 4.26; p=0.29). Conclusions: The administration of single-dose intra-articular bupivacaine plus morphine after knee arthroscopic surgery is effective for pain relief, and its short-term side effects remain similar to saline placebo.研究目的：评估膝关节关节镜手术后单次关节腔内注射布比卡因联合吗啡的疗效与安全性。研究设计：荟萃分析（Meta-analysis）。数据来源与研究纳入标准：通过检索Medline（1966年-2014年）、Cochrane对照试验中心注册库以及Embase数据库，全面查找以单次关节腔内注射布比卡因联合吗啡用于术后镇痛的随机安慰剂对照试验。研究结果：本荟萃分析共纳入12篇文献。布比卡因联合吗啡组的平均视觉模拟评分法（Visual Analogue Scale, VAS）得分显著低于安慰剂组（加权均数差（Weighted Mean Difference, WMD）=-1.75；95%置信区间（Confidence Interval, CI）：-2.16~-1.33；p<0.001）。布比卡因联合吗啡组末次随访时点的VAS得分同样显著低于安慰剂组（WMD=-1.46；95%CI：-1.63~-1.29；p<0.001）。需行补救镇痛的患者数量亦显著减少（相对危险度（Relative Risk, RR）=0.60；95%CI：0.39~0.93；p=0.02），而首次镇痛请求时间（WMD=3.46；95%CI：-1.81~8.72；p=0.20）与短期不良反应发生率（RR=1.67；95%CI：0.65~4.26；p=0.29）与安慰剂组无显著差异。研究结论：膝关节关节镜手术后单次关节腔内注射布比卡因联合吗啡可有效缓解术后疼痛，且其短期不良反应发生率与生理盐水安慰剂组无显著差异。