Management of postoperative pain following carpal tunnel release using opioids vs non-opioids: A comprehensive systematic review of the literature.

IF 1.8 4区医学 Q2 ORTHOPEDICS

Journal of Hand Therapy Pub Date : 2025-07-03 DOI:10.1016/j.jht.2025.05.007

Anwar A Alsakaker, Abdulaziz F Abumelha, Nouf Turki Ashgan, Rana Khalid Baowaydhan, Ghadah A Almahbub, Marah M Alsulami, Renad I Alnujaidi, Dalia F Alhabeeb, Abdulaziz Alabdulkarim

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引用次数: 0

Abstract

Background: There is a lack of clear guidelines on best practices for managing pain after carpal tunnel release (CTR) using opioids and non-opioids.

Purpose: The purpose of this review is to present the available evidence specific to the use of opioids and non-opioids to manage pain following CTR.

Study design: Systematic review.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed for searching MEDLINE, Cochrane Central Register of Controlled Trials, Excerpta Medica Database, and Web of Science databases for English language using the keywords carpal tunnel, wrist surgery, and postoperative pain. Randomized controlled trials and cohort studies that compared the pharmacological use of oral opioids and non-opioids and patient-reported pain outcomes were included.

Results: Initially, 2861 articles were identified. After applying predefined inclusion and exclusion criteria and conducting full-text screening, five randomized controlled trials totaling 691 patients were included. A comparative synthesis of these trials revealed that reported pain scores and mean pill consumption did not differ significantly between patients prescribed opioids vs non-opioids.

Conclusions: Based on this limited review of five studies, the use of non-opioids, such as acetaminophen or ibuprofen, is not inferior to opioids for management of pain following CTR. Most authors recommend a multimodal analgesic approach combining acetaminophen and ibuprofen.

查看原文本刊更多论文

阿片类药物与非阿片类药物对腕管释放术后疼痛的处理：文献的全面系统回顾。

背景：对于使用阿片类药物和非阿片类药物治疗腕管释放（CTR）后疼痛的最佳实践，缺乏明确的指导方针。目的：本综述的目的是提供阿片类药物和非阿片类药物用于治疗CTR后疼痛的现有证据。研究设计：系统评价。方法：按照系统评价和meta分析指南的首选报告项目，在MEDLINE、Cochrane中央对照试验注册库、摘录医学数据库和Web of Science数据库中检索关键词腕管、手腕手术和术后疼痛的英语语言。随机对照试验和队列研究比较了口服阿片类药物和非阿片类药物的药理学使用以及患者报告的疼痛结果。结果：初步鉴定出2861篇文献。采用预先设定的纳入和排除标准并进行全文筛选后，纳入5项随机对照试验，共计691例患者。这些试验的比较综合显示，在处方阿片类药物和非阿片类药物的患者之间，报告的疼痛评分和平均药片消耗量没有显着差异。结论：基于对五项研究的有限回顾，使用非阿片类药物，如对乙酰氨基酚或布洛芬，在治疗CTR后疼痛方面并不逊于阿片类药物。大多数作者推荐多模式镇痛方法，包括对乙酰氨基酚和布洛芬。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hand Therapy 医学-外科

CiteScore

3.50

自引率

10.00%

发文量

审稿时长

19.2 weeks

期刊介绍： The Journal of Hand Therapy is designed for hand therapists, occupational and physical therapists, and other hand specialists involved in the rehabilitation of disabling hand problems. The Journal functions as a source of education and information by publishing scientific and clinical articles. Regular features include original reports, clinical reviews, case studies, editorials, and book reviews.