Study designs of evaluations included in the review
Randomised controlled trials (RCTs) that were double-blind and had at least 10 patients per treatment group.
Specific interventions included in the review
Comparisons were made with NSAIDS administered intravenously or intramuscularly, or with placebo or no treatment. Comparisons had to be of a local NSAID with the same dose of systemic NSAID, of a local NSAID with placebo or no treatment, or of different doses of a local NSAID. The interventions included in the review were local infiltration with NSAIDs (30 or 60 mg ketorolac; 5, 7.5, 10 or 20 mg tenoxicam) administered either by intra-articular injection (i.a.), as intravenous regional anaesthesia (IVRA) or intra-wound (i.w.).
Participants included in the review
All patients with post-operative pain were eligible for inclusion in the review; of those studies included, participants were undergoing various surgical procedures such as arthroscopy, elective hand surgery, herniorrhaphy, mastectomy and tonsillectomy. There was a link between the mode of local application of NSAID and the type of surgery undergone by the participants. All studies of i.a. injection of NSAIDs involved patients undergoing arthroscopy. All studies of IVRA involved patients undergoing elective hand surgery. Studies of i.w. application were more varied, involving studies of patients undergoing herniorrhaphy, mastectomy and one each of elective hand surgery and tonsillectomy.
Outcomes assessed in the review
Difference between the treatments were assessed using pain scores, consumption of supplementary analgesics and/or time to first analgesic request. Weighted mean differences of visual analogue scale (VAS) scores were calculated.
How were decisions on the relevance of primary studies made?
The authors do not state how the papers were selected for the review, or how many of the authors performed the selection.