The role of preemptive analgesia with various analgesic drugs in patients undergoing orthopedic surgeries: A systematic review 2015–2020

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Introduction: Effective postoperative pain management remains a major challenge, particularly in orthopedic surgeries, as poor control can increase patient stress, prolong opioid use, and delay recovery and hospital discharge. This structured review aimed to evaluate the effectiveness of various analgesic agents in preventing or reducing postoperative pain in patients undergoing orthopedic procedures. Methods: A comprehensive systematic search was conducted in the Web of Science, PubMed, and Scopus databases from 2015 up to the end of December 2020. Additionally, the reference lists of relevant articles were screened to identify further eligible studies. Only randomized clinical trials investigating preemptive analgesia in orthopedic surgery patients were included. Results: Fourteen articles were initially identified, with five studies meeting the final inclusion criteria. These trials investigated the effects of different pharmacological agents on preemptive pain control. Analgesic effects were observed with intravenous ibuprofen administered prior to incision.For dexketoprofen and tramadol, analgesic benefits were reported in postoperative administration protocols rather than true pre-incision (preemptive) use. Conclusion: Preemptive administration of intravenous ibuprofen appears effective in reducing postoperative pain in adults undergoing orthopedic surgery. Evidence for dexketoprofen and tramadol relates primarily to postoperative or perioperative use rather than true preemptive administration.

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