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Meta-Analysis
. 2017 Nov 21;12(1):179.
doi: 10.1186/s13018-017-0682-0.

The effect of midazolam on pain control after knee arthroscopy: a systematic review and meta-analysis

Xiaojun Chen  1 , Xiaoqing Mou  2 , Zhiyu He  1 , Yong Zhu  3
Affiliations
Meta-Analysis

The effect of midazolam on pain control after knee arthroscopy: a systematic review and meta-analysis

Xiaojun Chen et al. J Orthop Surg Res. .

Abstract

Background: Midazolam has some potential in pain control of patients undergoing knee arthroscopy. However, the results remain controversial. We conduct a systematic review and meta-analysis to explore the effect of midazolam on pain control after knee arthroscopy.

Methods: PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases are systematically searched. Randomized controlled trials (RCTs) assessing the effect of midazolam on pain management after knee arthroscopy are included. Two investigators have independently searched articles, extracted the data, and assessed the quality of the included studies. This meta-analysis is performed using the random-effect model.

Results: Six RCTs are included in this meta-analysis. Compared with control intervention after knee arthroscopy, midazolam intervention can significantly reduce the pain scores (standard mean difference (Std. MD) = - 3.70; 95% confidence interval (CI) = - 6.81 to - 0.60; P = 0.02), the number of patients requiring analgesics (risk ratio (RR) = 0.66; 95% CI = 0.49 to 0.88; P = 0.005), and analgesic consumption (Std. MD = -1.62; 95% CI = - 3.04 to - 0.19; P = 0.03), as well as increase the time to first analgesic requirement (Std. MD = 1.58; 95% CI = 0.17 to 2.99; P = 0.03). In addition, midazolam intervention results in no increase in adverse events following knee arthroscopy (RR = 0.74; 95% CI = 0.18 to 2.98; P = 0.67).

Conclusions: Midazolam intervention is revealed to substantially reduce the pain scores, the number of patients requiring analgesics, and analgesic consumption, as well as improve the time to first analgesic requirement after knee arthroscopy.

Keywords: Knee arthroscopy; Meta-analysis; Midazolam; Pain control; Pain scores.

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Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Flow diagram of study searching and selection process
Fig. 2
Fig. 2
Forest plot for the meta-analysis of the pain scores
Fig. 3
Fig. 3
Forest plot for the meta-analysis of the time to first analgesic requirement (min)
Fig. 4
Fig. 4
Forest plot for the meta-analysis of the number of patients requiring analgesics
Fig. 5
Fig. 5
Forest plot for the meta-analysis of analgesic consumption (mg)
Fig. 6
Fig. 6
Forest plot for the meta-analysis of adverse events
See this image and copyright information in PMC

References

    1. Cagla Ozbakis Akkurt B, Inanoglu K, Kalaci A, Turhanoglu S, Asfuroglu Z, Tumkaya F. Effects of intravenous small dose ketamine and midazolam on postoperative pain following knee arthroscopy. Pain Prac. 2009;9:289–295. doi: 10.1111/j.1533-2500.2009.00278.x. - DOI - PubMed
    1. Dahl MR, Dasta JF, Zuelzer W, McSweeney TD. Lidocaine local anesthesia for arthroscopic knee surgery. Anesth Analg. 1990;71:670–674. doi: 10.1213/00000539-199012000-00016. - DOI - PubMed
    1. Pavlin DJ, Chen C, Penaloza DA, Buckley FP. A survey of pain and other symptoms that affect the recovery process after discharge from an ambulatory surgery unit. J Clin Anesth. 2004;16:200–206. doi: 10.1016/j.jclinane.2003.08.004. - DOI - PubMed
    1. Chou R, Gordon DB, de Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T, et al. Management of postoperative pain: a clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016;17:131–157. doi: 10.1016/j.jpain.2015.12.008. - DOI - PubMed
    1. Gordon DB, de Leon-Casasola OA, Wu CL, Sluka KA, Brennan TJ, Chou R. Research gaps in practice guidelines for acute postoperative pain management in adults: findings from a review of the evidence for an American Pain Society Clinical Practice Guideline. J Pain. 2016;17:158–166. doi: 10.1016/j.jpain.2015.10.023. - DOI - PubMed

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