Can Preoperative Intravenous Corticosteroids Administration Reduce Postoperative Pain Scores Following Spinal Fusion?: A Meta-Analysis.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2020;8(21):18 J Invest Surg. 2020 Apr;33(4):307-316.¿Qué significa esto para mi consulta?
The results of this meta-analysis suggest that pre-operative corticosteroid injections can be effective after post-spinal surgery in reducing pain, opioid consumption, and the incidence of nausea and vomiting. However, limitations exist in this study, as the dosage of corticosteroids differed between studies and the included sample size was small. Furthermore, high heterogeneity was observed for pooled outcomes. Future studies should also focus on long-term outcomes.
Resumen del estudio
A total of 10 randomized controlled trials containing 998 patients undergoing spinal fusion surgery were included in this meta-analysis comparing the treatment of pre-operative intravenous corticosteroids or placebo. The primary pooled outcome of interest was pain on a Visual Analogue Scale (VAS) post-operation. Additional pooled outcomes included the post-operative nausea occurrence, the incidence of infection, total morphine consumption, and length of hospital stay post-spinal fusion surgery. For the primary outcome, the results showed statistically significantly favourable pooled scores in the corticosteroid group compared to the placebo at all timepoints (12, 24, 48, 72-hours post-surgery) and overall (p<0.00001). Similar results were found for all other outcomes including postoperative nausea occurrence, total morphine consumption, length of hospital stay (all p<0.00001), except for the incidence of infection (p=0.57). Furthermore, subgroup analyses were conducted for high-dose (≥10 mg) to low-dose (<10 mg) corticosteroids for VAS pain at 12-hours post-surgery: pooled scores were statistically significantly favorable in the corticosteroid group (p=0.001 for both).
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