Table 1.
Study information.
| Author | Basic analgesic regimen all groups | Type of supplemental analgesics | Analgesics in intervention and control groups Type, dose, volume, time points, and type of administration |
|---|---|---|---|
| Abrishamkar, 2012 | Routine analgesic protocol | Morphine s.c. VAS > 4 | 1: (n = 22) ketamine 0.5 mg/kg/h i.v. Control: (n = 23) morphine s.c. |
| Aglio, 2018 | None | Hydromorphone i.v. | 1: (n = 33) hydromorphone 0.5 mg; epidural preoperatively 2: (n = 34) bupivacaine 31.25 mg and hydromorphone 0.5 mg; epidural preoperatively Control: (n = 32) saline 10 mL; epidural preoperatively |
| Aubrun, 2000 | Propacetamol 2 g p.o. every 6 hours. | Morphine i.v. | 1: (n = 25) ketaprofen 100 mg i.v. at the end of surgical procedure Control: (n = 25) dextrose |
| Brinck, 2020 | i.v. paracetamol | PCA oxycodone | 1: (n = 65) ketamine bolus pre-incisional (0.5 mg/kg), followed by S-ketamine infusion of 0.12 mg/kg/h 2: (n = 62) ketamine bolus pre-incisional (0.5 mg/kg), followed by S-ketamine infusion of 0.6 mg/kg/h Control: (n = 62) matching saline pre-incisional |
| Brown, 2018 | PCA morphine | 1: (n = 24) liposomal bupivacaine 266 mg, 60 mL before wound closure; local anaesthetic Control: (n = 26) saline 60 mL before wound closure; local anaesthetic |
|
| Choi, 2014 | Premedicated with acetaminophen 1,000 mg and gabapentin 600 mg PO After surgery, acetaminophen 1,000 mg every 6 hours and oral gabapentin 200 mg every 8 hours. |
PCA hydromorphone | 1: (n = 20) hydromorphone + bupivacaine 0.6 mg bolus (hydromorphone) Bupi + hydromorphone 15 μg 6 mL/h 0.1%; epidural at PACU Control: (n = 18) matching saline; epidural at PACU |
| Dehkordy, 2020 | Paracetamol 1 gr | PCA morphine per demand meperidine 50 mg rescue agent | 1: (n = 40) magnesium i.v. 50 mg/kg bolus followed by a continuous 15 mg/kg/h infusion. Before induction + during surgery Control: (n = 40) matching saline |
| Dhaliwal, 2019 | Acetaminophen, oxycodone, codein, morphine i.v. | PCA morphine | 1: (n = 74) morphine 0.2 mg, 0.4 mL saline before wound closure; spinal Control: (n = 76) matching saline |
| Firouzian, 2018 | None | PCA morphine | 1: (n = 40) naloxone 20 μg + morphine 0.2 mg i.t.; end of surgery Control: (n = 37) morphine 0.2 mg i.t.; end of surgery |
| France, 1997 | None | PCA opioids | 1: (n = 42) duramorph injection 0.011 mg/kg; 30 minutes before surgery Control: (n = 26) matching saline |
| Fujita, 2016 | Indomethacin sup. (50 mg, first choice) pentazocine hydrochloride (15 mg IM, second choice) | PCA morphine | 1: (n = 30) pregabalin 75 mg, 2 hours Prior to surgery 2: (n = 30) pregabalin 150 mg, 2 hours before surgery Control: (n = 29) diazepam 5 mg, 2 hours before surgery |
| Ghabach, 2019 | Paracetamol 1 g every 8 hours and ketoprofen 50 mg every 12 hours i.v. | Sufentanil i.v. 5 mg to reach a VAS score <4 Meperidine 50 mg IM (VAS score 4). |
1: (n = 14) ropivacaine 0.5% 10 mL before wound closure; sponge Control: (n = 16) saline 10 mL before wound closure sponge |
| Ghamry, 2019 | Paracetamol i.v. 1 g per 6 hours, Ketorolac 30 mg loading dose then 15 mg per 8 hours. | Morphine 0.1 mg/kg i.v. (VAS >30) | 1: (n = 30) bupivacaine 0.25%, 20 mL erector spinae block Control: (n = 30) none |
| Gottschalk, 2004 | None | PCA pirimidine | 1: (n = 13) ropivacaine 0.1% 12 mL/hr during surgery; epidural postoperatively Control: (n = 13) matching saline; epidural postoperatively |
| Greze, 2017 | Acetaminophen (1 g x 4 daily), ketoprofen (100 mg x 2 daily) nefopam (20 mg x 4 daily) | PCA morphine | 1: (n = 19) ropivacaine 10 mL bolus + 8 mL/h for 48 hours; end of surgery; wound infiltration Control: matching saline; wound infiltration |
| Hadi, 2010 | None | PCA morphine | 1: (n = 15) ketamine i.v. 1 µg/kg/min; during surgery Control: (n = 15) none |
| Martí/Hernandez-Palazón, 2001 | None | PCA morphine | 1: (n = 21) propacetamol 2 g i.v. every 6 hours; during a period of 72 hours. Control: (n = 21) matching saline |
| Ibrahim, 2018 | Ketorolac 30 mg i.v. and paracetamol 1 g injection for 8 hours | Morphine i.v. VAS was ≥4, or by request | 1: (n = 20) lidocaine i.v. loading before incision then 3 mg/kg/h; during surgery Control: (n = 20) matching saline |
| Kang, 2013 | None | PCA fentanyl | 1: (n = 32) ropivacaine 0.1% 10 mL 20 minutes; before skin incision; epidural Control: (n = 34) matching saline |
| Kawamata, 2005 | Pre-med: 3 mg i.m. midazolam. Post-med: 200 μg i.v. buprenorphine at 1 mL/h rate s.c. | Flurbiprofen 50 mg i.v. | 1: (n = 16) buprenorphine 1.2 + 1 mg droperidol, total 48 mL, 1 mL/h for 48 hours after surgery; continuous s.c. infusion Control: (n = 17) buprenorphine 0.6 mg + droperidol 1 mg, total 48 mL, 1 mL/h for 48 hours after surgery continuous s.c. infusion |
| Kien, 2019 | None | Morphine 2 mg every 3 minutes Until VAS <4 PCA morphine rescue analgesia with fentanyl |
1: (n = 30) pregabalin 150 mg P.O., celecoxib 200 mg P.O., 2 hours before surgery Control: (n = 30) placebo |
| Kim, 2011 | None | PCA fentanyl ketorolac 120 mg, ketorolac 30 mg i.v. VAS >5 | 1: (n = 18) pregabalin 75 mg P.O. 1 hour before surgery 2: (n = 17) pregabalin 50 mg P.O. 1 hour before surgery Control: (n = 17) placebo |
| Kim, 2013 | Ketorolac 30 mg i.v. 10 minutes before skin closure | i.v. morphine | 1: (n = 32) ketamine i.v. infusion of 1 μg/kg/min after bolus 0.5 mg/kg, before skin incision + continued 48 hours postoperatively 2: (n = 32) ketamine 2 μg/kg/min after bolus 0.5 mg/kg before skin incision + continued 48 hours postoperatively Control: (n = 32) matching saline |
| Kim, 2016 | None | PCA morphine | 1: (n = 40) celecoxib 200 mg, pregabalin 75 mg, acetaminophen 500 mg, extended-release oxycodone 10 mg 1 hour preop + twice daily Control: (n = 40) morphine i.v. |
| Levaux, 2003 | Piritramide just before wound closure | PCA piritramide 1 mg piritramide bolus until pain free in emergence |
1: (n = 12) magnesium 50 mg/kg i.v. preoperatively Control: (n = 12) saline i.v. preoperatively |
| Li, 2019 | Ropivacaine 0.5% 20 mL 5 minutes Before incision | PCA morphine | 1: (n = 29) dexmedetomidine 20 mL, 0.5% ropivacaine 1 µg/kg dexmedetomidine 5 minutes before incision Control: (n = 28) 20 mL 0.5% ropivacaine 5 minutes before incision |
| Oh, 2019 | None | PCA fentanyl Hydromorphone 6 mg and nefopam 100 mg |
1: (n = 43) rocuronium 2 mg/mL diluted in 0.9% isotonic saline and started at 15 mL/hr Control: (n = 40) none |
| Pinar, 2017 | Lyrica 150 mg Preop PCM 1 g i.v. per 6 hours |
PCA morphine | 1: (n = 21) pregabalin 150 mg 1 hour preop and ibuprofen 300 mg 30 minutes preoperatively Control: (n = 21) pregabalin 150 mg 1 hour preoperatively |
| Quinlan, 2017 | None | Hydromorphone i.v. | 1: (n = 74) 1 L of crushed ice every 4 hours postoperatively applied to the lower back for 20 minutes Control: (n = 74) none |
| Raja, 2019 | Paracetamol 1 g i.v., dexamethasone 8 mg i.v. after skin incision; postop: paracetamol 1 g i.v. every 6 hours, ketorolac 30 mg every 8 hours, pregabalin P.O. 75 mg | PCA morphine | 1: Paracetamol 1 g, ketorolac 20 mg, pregebalin 75 mg P.O. 4 hours before surgery Control: (n = 50) none |
| Reuben, 2006 | None | PCA, morphine | 1: (n = 20) celecoxib 400 mg + placebo capsule, 1 hour before induction; celecoxib 200 mg + placebo capsules, 12 hours after surgery. 2: (n = 20) pregabalin 150 mg + placebo capsules, 1 hour before induction; pregabalin 150 mg + placebo capsules, 12 hours after surgery 3: (n = 20) celecoxib 400 mg + pregabalin 150 mg 1 hour before induction; celecoxib 200 mg + pregabalin 150 mg, 12 hours after surgery Control: (n = 20) matching placebo capsula |
| Šervicl-kuchler, 2014 | Metamizole 2.5 g per 12 hours | PCA piritramide piritramide 3 mg i.v., VAS >4 | 1: (n = 25) levobupivacaine 0.125% 0.1 mL/kg/h after wound closure; epidural postoperatively Control: (n = 25) matching saline postoperatively |
| Singhatanadgige, 2020 | Celecoxib 400 mg pregabalin 75 mg, paracetamol 500 mg | PCA morphine | 1. (n = 40) bupivacaine 0.5%, 92.5 mg. (18.5 mL), ketorolac 30 mg (1 mL), morphine 5 mg(0.5 mL), and epinephrine 0.5 mg (0.5 mL); end of surgery; wound infiltration Control: (n = 40) bupivacain, ketorolac, epinephrine; end of surgery; wound infiltration |
| Siribumrungwong, 2015 | Paracetamol 500 mg P.O. | i.v. morphine | 1: (n = 32) parecoxib 40 mg i.v. 30 minutes before surgery 2: (n = 32) keterolac 30 mg i.v. 30 minutes before surgery Control: (n = 32) matching saline |
| Song, 2013 | None | Fentanyl 0.5 µg/kg i.v. 20 minutes before wound closure +2 mL/hr; fentanyl i.v. postoperatively; postop: PCA fentanyl (2 mL on demand) postoperatively + 25 mg meperidine i.v. VAS >40 or requested | 1: (n = 24) ketamine 0.3 mg/kg before surgery +3 mg/kg mixed to i.v. PCA on demand in PACU, after induction + postoperatively Control: (n = 25) matching saline |
| Subramaniam, 2011 | None | PCA hydromorphone epidural bupivacaine | 1: (n = 15) ketamine bolus 0.15 mg/kg at induction and continued on 2 mg/kg/min infusion intraoperatively and postoperatively for 24 hours Control: (n = 15) saline bolus at induction and continued as i.v. infusion for 24 hours |
| Urban, 2008 | None | Perop: spinal morphine before wound closure postop: PCA hydromorphone ketamine if NRS = 10 | 1: (n = 12) ketamine i.v. 0.2 mg/kg at induction of GA and 2 μg/kg/h until discharge from PACU Control: (n = 12) none |
| Urban, 2018 | Acetaminophen | PCA hydromorphone | 1: (n = 43) pregabalin 150 mg po, 1hour prior to surgery Control: (n = 43) placebo capsula po, 1 hour prior to surgery |
| Wang, 2020 | Diclofenac 50 mg supp. Parecoxib 50 mg i.v. | PCA sufentanil | 1: (n = 44) 0.2 mg of morphine, 2 mL of saline, 30 minutes before anesthesia induction i.t. |
| Wen, 2016 | None | PCA sufentanil | 1: (n = 20) dezocine 0.1 mg/kg i.v. 5 minutes before suturing the skin 2: (n = 20) dezocine 0.15 mg/kg i.v. 5 minutes before suturing skin 3: (n = 20) dezocine 0.20 mg/kg i.v. 5 minutes before suturing skin Control: (n = 20) matching saline |
| Yamashita, 2006 | None | PCA morphine morphine i.v. 0.1 mg/kg during surgery | 1: (n = 12) flurbiprofen 1 mg/kg i.v. before surgery 2: (n = 12) flurbiprofen 1 mg/kg i.v. after surgery Control: (n = 12) placebo |
| Yeom, 2012 | None | Postop: 1 μg/kg fentanyl i.v. Loading dose + i.v. fentanyl 0.4 μg/kg/mL at 1 mL/h PCA fentanyl |
1: (n = 20) sevoflurane-nitrous oxideoxygen, thiopental sodium 4–5 mg/kg, rocuronium 0.6–0.7 mg/kg maintained with sevoflurane and 50% nitrous oxide in oxygen (3 L/min); before and during surgery; i.v. and inhalation 2: (n = 20) sevoflurane-remifentanil-nitrous oxide-oxygen, thiopental sodium 4–5 mg/kg, rocuronium 0.6–0.7 mg/kg, remifentanil infusion, and sevoflurane inhalation was maintained with sevoflurane, remifentani infusion, and 50% nitrous oxide in oxygen (3 L/min); before and during surgery; i.v. + inhalation 3: (n = 20) propofol-remifentanil-oxygen) propopol and remifentanil infusion, rocuronium 0.6–0.7 mg/kg, anesthesia was maintained with propofol, remifentanil and 50% oxygen (3 L/min); before and during surgery; i.v. + inhalation |
| Zhang, 2020 | Flurbiprofen 1.5 mg/kg at end of surgery | PCA sufentanil NRS > 40 | 1: (n = 30) ropivacaine 0.4% 20 mL, erector spinae block Control: (n = 30) sham block |
| Ziegler, 2008 | Diclofenac 100 mg supp. | PCA piritramide | 1: (n = 23) morphine 0.4 mg before wound closure i.t. Control: (n = 23) matching saline |
i.t., intrathecal; i.v. intravenous; PCA, patient-controlled analgesia; NRS, numerical rating scale; VAS, visual analog scale.