The efficacy of intra-articular fentanyl supplementation for knee arthroscopy: A meta-analysis of randomized controlled studies.

Abstract

The efficacy of intra-articular fentanyl supplementation for pain control after knee arthroscopy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of intra-articular fentanyl supplementation for pain intensity after arthroscopic knee surgery. We searched PubMed, EMbase, Web of Science, EBSCO, and Cochrane Library databases through May 2019 for randomized controlled trials (RCTs) assessing the efficacy and safety of intra-articular fentanyl supplementation for arthroscopic knee surgery. This meta-analysis is performed using the random-effects model. Four RCTs are included in the meta-analysis. Overall, compared with control group after knee arthroscopy, intra-articular fentanyl supplementation is associated with reduced pain scores at 1 h (standard mean difference (Std MD) = -3.50; 95% confidence interval (CI) = -5.68 to -1.32; <i>p</i> = 0.002), 2 h (Std MD = -4.73; 95% CI = -8.75 to -0.71; <i>p</i> = 0.02), and 8 h (Std MD = -5.02; 95% CI = -9.73 to -0.30; <i>p</i> = 0.04) but shows no substantial impact on pain scores at 4 h (Std MD = -3.94; 95% CI = -7.93 to 0.05; <i>p</i> = 0.05) or the supplementary analgesia (risk ratio = 0.56; 95% CI = 0.09-3.59; <i>p</i> = 0.54). Intra-articular fentanyl supplementation does benefit in pain control after knee arthroscopy.