The efficacy of intraoperative periarticular injection in Total hip arthroplasty: a systematic review and meta-analysis

Abstract

Background Periarticular injection (PAI) is a regional analgesia method performed in total hip arthroplasty (THA) for postoperative pain relief. However, its efficacy and safety is still inconclusive. Therefore, we conducted this meta-analysis to assess the safety of PAI and to determine if PAI provides better pain relief and reduce the consumption of opioids after THA. Methods We searched PubMed, Web of Science, Embase and the Cochrane Library comprehensively. Only randomized control trials were included in our meta-analysis. Eleven studies that compared the efficacy of PAI with the control group were included. The preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines and Jadad score were applied to assess the quality of the included studies. We used the recommendations by the Cochrane Collaboration to reduce bias and to ensure our results were reliable and veritable. Results Our analysis demonstrated that PAI was more effective than the control group with a lower visual analog scale (VAS) score during rest at 24 h ( P = 0.003), 48 h ( P = 0.002), and VAS score with activity at 24 h ( P = 0.04). There was also less amount of opioid consumption ( P = 0.01). There were no differences in length of hospital stay ( P = 0.526) and postoperative nausea rate ( P = 0.153). Conclusion Compared with the control group, PAI showed better pain relief and less amount of opioid consumption after THA. Our meta-analysis suggests that PAI is a safe and effective multimodal analgesia technique that can be used for THA. Electronic supplementary material The online version of this article (10.1186/s12891-019-2628-7) contains supplementary material, which is available to authorized users.

Do intra‐articular injections of analgesics improve outcomes after temporomandibular joint arthrocentesis?: A systematic review and meta‐analysis

“…Despite the different opioids used in the included studies, data were pooled together for a meta-analysis as they belonged to the same class of drugs. 38 Previous meta-analysis studies have also pooled different opioids for pain relief in a single meta-analysis. 39,40 On the pooling of data, we found significantly reduced pain with the use of intra-articular opioids at all time points.…”

The efficacy of continuous versus single-injection femoral nerve block in Total knee Arthroplasty: a systematic review and meta-analysis

“…We followed the statement on preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines (Table 1) and searched a comprehensive search on databases including PubMed, Embase, the Cochrane Library and Web of Science from the earliest record to September 2019. The following searching strategy was similar to the article we have published before [15]. We reviewed all of the articles that discussed continuous femoral nerve block (cFNB) versus singleinjection femoral nerve block (sFNB) in TKA.…”

Perioperative Pain Management in Patients Undergoing Total Hip Arthroplasty: Where Do We Currently Stand?

“…It is worth mentioning that liposomal bupivacaine has been associated with more superior outcomes in patients undergoing THR compared to traditional bupivacaine [ 29 ]. Apart from that, a considerable number of studies have reported that LIA is associated with more sufficient postoperative analgesia and less opioid consumption [ 30 - 34 ]. Furthermore, another recent study has suggested that LIA not only represents an effective method of analgesia but it also leads to a reduced length of stay in the hospital [ 35 ].…”