Kuwait Institute for Medical Specializations, Kuwait City, Kuwait. Faculty of Medicine, Ain Shams University, Cairo, Egypt. Biomedical Informatics and Medical Statistics Department, Medical Research Institute, Alexandria University, Egypt. Faculty of Medicine Al-Azhar University, Damietta, Egypt. College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America.
Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery. 2022
AIM: To conduct a systematic review and meta-analysis of all randomized controlled trials (RCTs) that evaluated the analgesic and anti-hemorrhagic efficacy of platelet-rich plasma (PRP) among patients undergoing tonsillectomy. METHODS PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar databases were screened from inception until July 2021, and updated in December 2021. Risk of
bias of the included studies was evaluated according to the Cochrane Collaboration tool. The efficacy endpoints were summarized as risk ratio (RR) or standardized mean difference (SMD) with 95% confidence interval (CI). RESULTS Seven RCTs were analyzed, comprising a total of 392 patients. Risk of bias evaluation showed an overall high risk in one RCT, low risk in four RCTs, and some concerns in two RCTs. The pooled results revealed that the mean postoperative pain score was significantly reduced in favor of the PRP group compared with the control group (SMD=-1.38, 95% CI [-1.91, -0.85], p<0.001). Subgroup analysis showed the effect estimate was statistically significant for early postoperative pain (day 0 to day 3), without substantial difference between both groups on late postoperative pain (day 5 and day 7). Moreover, the rate of postoperative hemorrhage was significantly reduced in favor of the PRP group compared with the control group (RR=0.16, 95% CI [0.05, 0.50], p=0.001). Subgroup analysis showed the effect estimate was statistically significant for the rate of primary and secondary hemorrhage. CONCLUSION PRP was associated with significant reduction in postoperative pain and hemorrhage among patients undergoing tonsillectomy. This article is protected by copyright. All rights reserved.