Perioperative adjuvant corticosteroids for post-operative analgesia in elective knee surgery - A systematic review

Syst Rev. 2017 Apr 27;6(1):92. doi: 10.1186/s13643-017-0485-8.

Abstract

Background: Elective knee surgery is performed to reduce chronic pain and improve function in degenerate knees. Treatment of acute post-operative pain is suboptimal in 75% of patients despite multimodal analgesic approaches resulting in higher post-operative opiate consumption. The effect of corticosteroids as an adjunct for post-operative pain control remains undefined.

Methods: The databases MEDLINE, EMBASE and CENTRAL (Cochrane library) will be searched from their inception to present using broad search criteria for eligible randomised/quasi-randomised controlled trials investigating perioperative corticosteroid adjunctive use in elective knee surgery. Meta-analyses will be conducted according to the recommendations from the Cochrane Handbook for Systematic Reviews of Interventions.

Discussion: This systematic review of the perioperative adjunctive use of corticosteroids will assess the analgesic effects, post-operative nausea and vomiting, opiate consumption, infection rates and time till discharge and assess whether adjunctive corticosteroids should be encouraged in elective knee surgery.

Systematic review registration: PROPSERO CRD42016049336.

Keywords: Analgesia; Corticosteroids; Knee; Perioperative; Surgery.

Publication types

  • Systematic Review

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Analgesics, Opioid / administration & dosage*
  • Elective Surgical Procedures / adverse effects*
  • Humans
  • Joint Diseases / drug therapy
  • Joint Diseases / physiopathology
  • Joint Diseases / surgery*
  • Knee Joint / drug effects
  • Knee Joint / physiopathology
  • Knee Joint / surgery*
  • Pain Measurement
  • Perioperative Care* / methods
  • Postoperative Pain / drug therapy*
  • Research Design*
  • Review Literature as Topic*
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Analgesics, Opioid