Systematic Reviews
Copyright ©The Author(s) 2024.
World J Orthop. Sep 18, 2024; 15(9): 882-890
Published online Sep 18, 2024. doi: 10.5312/wjo.v15.i9.882
Table 1 Participants, intervention, comparison, outcomes, study design method for selecting clinical studies for the systematic reviews
Participants
Intervention
Comparison
Outcomes
Study design
Adult patients with catastrophic orthopedic trauma Opioid medicationsNon-opioid medicationsA minimum clinically important difference in painRandomized controlled trials and observational studies
Table 2 Characteristics of the studies included in the qualitative synthesis
Ref.
Country/year
Injury
Opioid(s)-ROA
Nonopioid(s)-ROA
Patients /study type
Outcome (minimum clinically important difference)
Evaluation time
Efficacy result
Safety results
Soave et al[8]Italy/1983Severe pain due to fracturesPentazocine-IVIndoprofen-IVThe 40/pseudo-RCTAny reduction on VASThe 0 minute, 30 minutes, 1 hour, 2 hours, 4 hours, 6 hoursPain relief in Pentazocine groupNo differences
Chang et al[9]United States/2017Acute extremity painOXY/APAP-PO, HYCOD/APAP-PO, COD/APAP-POIBP/APAP-PO416/RCTReduction of 1.3 on the NRS2 hours No differencesADR in opioid
Bijur et al[10]United States/2021Acute musculo-skeletal painOXY/APAP-PO, HYCOD/APAP-PO, COD/APAP-POIBP/APAP-PO600/RCTAny reduction on NRSThe 0 hour, 1 hour or 2 hoursNo differencesADR in opioid
Buccelletti et al[11]Italy/2014Acute musculo-skeletal traumatic painCOD/APAP-POKetorolac-PO134/pseudo-RCTAny reduction on NRSThe 0 minute, 30 minutes,
2 hours
Pain relief in COD/APAP groupNot available
Craig et al[12]United Kingdom/2012Severe traumatic limb painMORPH-IVAPAP-IV55/RCT≥ 13 mm reduction on VASThe 0 minute, 5 minutes, 15 minutes, 30 minutes, 60 minutesNo differencesADR in opioid
Jalili et al[13]Iran/2016Severe traumatic limb painMORPH-IVAPAP-IV60/RCTAny reduction on NRSThe 0 minute, 15 minutes, 30 minutesPain relief in APAP groupNo differences
Farahmand et al[14]Iran/2018Severe traumatic limb painMORPH-IVLidocaine-IV50/RCTReduction of 1.3 on the NRSThe 0 minute, 15 minutes, 30 minutes, 45 minutes, 60 minutesNo differencesHeart rate/respiratory rate reduction in opioid
Gurnani et al[15]India/1996
Acute musculo-skeletal traumatic painMORPH-IVKET-subcutaneous40/RCTAny reduction on VASThe 0 minute, 15 minutes, 1 hour, 2 hours, 4 hours, 8 hours, 12 hours, 24 hoursPain relief in KET groupADR in opioid
Shimonovich et al[16]Israel/2016Moderate-severe acute traumatic painMORPH-IV/MORPH-IMKET-IN90/RCT≥ 15 mm reduction and max pain reduction on VASTime to onset in minNo differencesNo differences
Tongbua et al[17]Thailand/2022Moderate-severe Musculo-skeletal pain MORPH-IVKET-IN74/RCTReduction of 1.3 on the NRSThe 0 minute, 15 minutes, 30 minutes, 45 minutes, 60 minutes, 75 minutes, 90 minutes, 105 minutes and 120 minutesNo differencesNo differences
Kampan et al[18]Thailand/2024Moderate-severe Musculo-skeletal pain (≥ 65)MORPH-IVKET-IN92/RCTReduction of 1.3 on the NRSThe 0 minute, 30 minutesNo differencesADR in opioid
Esfahani et al[19]Iran/2021Severe traumatic limb painMORPH-IVKET-IV76/RCTAny reduction on NRSThe 0 minute, 5 minutes, 10 minutes, 15 minutes, 20 minutes, 25 minutes, 30 minutesNo differencesADR in KET
Le Cornec et al[20]France/2024Out-of-hospital traumatic painMORPH-IVKET-IV251/RCTReduction of 1.3 on the NRSThe 0 minute, 30 minutesNo differencesADR in KET
Lim et al[21]Singapore/ 2021Out-of-hospital traumatic painTramadol-IMMTX-inhalation369/RCT ≥ 3-point reduction
in NRS
The 0 minute, 5 minutes, 10 minutes, 15 minutes, 20 minutesPain relief in MTX groupADR in MTX