فهرست نشریات علمی دسترسی آزاد ایران

Background and Objectives: Pain relief in adults undergoing orthopaedic surgery needs more attention. To compare the efficacy and safety of ketorolac for postoperative orthopaedic procedures in adults, and to provide evidence-based references for clinical administration.   Methods: PubMed, Embase, and Web of science databases were searched to collect information on randomised controlled trials (RCTs) of ketorolac for postoperative analgesia in orthopaedics, and the time limit for searching was from the establishment of the databases to 1 February 2023, with no language restriction. Data were extracted independently by two investigators, article quality assessment was performed and cross-checked. After screening the literature and extracting the data, the quality of the included literature was evaluated using the risk of bias assessment tool recommended by the Cochrane Systematic Evaluator's Handbook 5.1.0; Meta-analyses, sensitivity analyses, and publication bias analyses were performed using RevMan 5.4 software. The outcome indicator was visual analogue scale (VAS) or numerical rating scale (NRS) to assess the effect of pain improvement, and the safety indicator was the number of adverse events.   Results: A total of 449 articles were obtained from the primary review and a total of 8 studies involving 854 investigators were included. Patients who received ketorolac for treatment had a lower rate of adverse events than controls [OR = 0.29, 95% CI (0.10,0.83), I2 = 0%≤50%, P = 0.02], 2-hour postoperative VAS score [MD: -0.41, 95% CI (-18.67,17.85), I2 = 92%>50%, P = 0.96] and 6-hour VAS scores [MD: 0.80, 95% CI (-5.41,7.01), I2 = 0≤50%, P = 0.80] were not statistically different from the control group. Subgroup analyses showed no statistically significant differences in gender [OR = 0.93, 95% CI (0.67,1.30), I2 = 0≤50%, P = 0.67], age [MD = -0.27, 95% CI (-3.13,2.59), I2 = 51%>50%, P = 0.85], weight [MD = -0.69, 95% CI (-3.23, and 1.85), I2 = 0 ≤ 50%, P = 0.59] and operative time [MD = 3.32, 95% CI (-7.55, 14.20), I2 = 91% > 50%, P = 0.55] did not affect the rate of outcome events. The results of the sensitivity study showed that the results of the current study had some stability. The results of publication bias analysis showed that the possibility of publication bias in this study was low.   Conclusion: Compared with other analgesic drugs, ketorolac does not have an advantage in postoperative VAS score reduction in orthopaedic surgery patients, but the incidence of adverse events is low.