The efficacy of periarticular drug infiltration for postoperative pain after total hip arthroplasty

Wang, Yanyang; Gao, Fuqiang; Sun, Wei; Wang, Bailiang; Guo, Wanshou; Li, Zirong

doi:10.1097/md.0000000000006401

Cited by 12 publications

(15 citation statements)

References 20 publications

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“…After this meta-analysis, there were additional literature about the efficacy of PAI in THA and the results remain inconclusive [7, 10–13, 15, 16]. Therefore, Wang et al [28] conducted a meta-analysis with a total of 666 THA patients from 8 randomized controlled trials to validate the efficacy of periarticular drug infiltration (PDI) for pain relief after THA surgery. The results showed that PDI group was associated with improved pain relief during rest but not with activity, less analgesic consumption and shorter length of hospital stay [24].…”

Section: Discussionmentioning

confidence: 99%

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

Hsiao

Chou

Tsai

et al. 2019

BMC Musculoskelet Disord

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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.

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Section: Discussionmentioning

confidence: 99%

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

Hsiao

Chou

Tsai

et al. 2019

BMC Musculoskelet Disord

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“…However, the SUCRA value indicated that FIB might be superior to FNB on alleviating pain 6 hours and 12 hours after THA. A previous meta‐analysis reported that PAI had efficacy superior over placebo in THA perioperative pain control . In our detailed analysis, we observed that the efficacy of PAI was significant only in the first 12 hours after surgery.…”

Section: Discussionmentioning

confidence: 48%

Comparing the efficacy of pain managements after total hip arthroplasty: A network meta‐analysis

Liu

YingBo

Liang

et al. 2018

J of Cellular Biochemistry

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The aim of our current study is to compare efficiency of various interventions implemented for pain management after total hip arthroplasty (THA). PubMed and EMBASE were searched for randomized clinical trials (RCTs) reporting the pain scales for evaluate the efficacy of pain control after THA including at least one pair of direct control groups. Pain scale values and the associated 95% credible interval (CrI) were used to describe efficacy. Surface under the cumulative ranking curve (SUCRA) of each means of pain control was calculated to compare the relative ranking of different interventions. Thirty-five eligible literatures were involved in data analysis. The interventions for postoperative pain management we examined were psoas compartment block (PCB), posterior nerve block (PNB), fascia iliaca block (FIB), periarticular injection (PAI), femoral nerve block (FNB), lumbar plexus block (LPB), spinal anesthesia (SA), epidural analgesia (EPI), intrathecal morphine (IA), intravenous patient-controlled analgesia (IV-PCA), patient-controlled analgesia (PCA), onsteroidal anti-inflammatory drug (NSAID), local infiltration analgaesia (LIA), and reverse LIA (rLIA). In 0 to 6 hours analysis, patients under SA were found to have significantly lower pain score and SA was ranked the best.In 6 to 12 hours analysis, SA was found to be significantly more effective than other interventions and its SUCRA was the highest. No intervention showed a significant effect on reducing pain score for 12 to 24 hours and 24 to 48 hours after THA. SA is the best intervention to reduce THA postoperative pain in the first 24 hours. LPB is a better choice to reduce pain 12 to 48 hours after THA. K E Y W O R D S analgesia, anesthesia, network meta-analysis, postoperative pain management, THA J Cell Biochem. 2019;120:4342-4354. wileyonlinelibrary.com/journal/jcb 4342 |

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“…They however noted no significant differences in activity related visual analogue score and complications between the 2 groups. 12 In our study, since both groups had similar preoperative and postoperative protocols, the differences in outcome could be inferred to be exclusively dependent on the type of perioperative analgesia used. It should be notedhowever, that the epidural catheter placement was done by anaesthesiologists with varying skill and experience, while the PIC was given by the primary surgeon.…”

Section: Discussionmentioning

confidence: 70%

“…The use of multimodal pain control combined with Periarticular Infiltration of Analgesic Cocktail (PIC) is an alternative to EA in THA.Multiple studies have shownthat periarticular infiltration using multimodal drugs can reduce the postoperative analgesia requirements and duration of hospitalization. [10][11][12] We hypothesized that PIC leads to lower postoperative pain, faster recovery, less opioid consumption and better patient satisfaction, when compared to EA.…”

Section: Introductionmentioning

confidence: 99%

How effective is periarticular drug infiltration in providing pain relief and early functional outcome following total hip arthroplasty?

Srampickal

Jacob

Kandoth

et al. 2019

Journal of Clinical Orthopaedics and Trauma

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The aim of the study was to compare the efficacy of periarticular injection of a cocktail of analgesic drugs (PIC) with epidural infiltration (EA), in providing postoperative pain relief and early functional improvement following Total Hip Arthroplasty (THA). Methods: 50 patients undergoing unilateral THA were randomized to receive either EA or PIC for postoperative pain control. Postoperative pain relief, as determined by the visual analogue scale (VAS), functional recovery and side effects related to EA and PIC were assessed. Results: PIC resulted in significantly lower VAS scores [0.48(0.71) vs 3.04(2.07)] in the first 24 h after surgery [mean (SD)], when compared to EA. The pain relief continued to be significantly lower even on the 10th postoperative day. Functional recovery was significantly better in the PIC group, with patients being able to walk longer distances and climb steps more quickly following THA. EA, unlike PIC was associated with side effects like nausea, vomiting, motor weakness, back pain and urinary retention. The overall satisfaction rate with treatment was significantly better in PIC group (9.04/10) than those who received EA (7.76/10). Conclusion: PIC provides significantly better pain control and functional recovery in the early postoperative period, with less side effects when compared with EA. PIC should be the choice for pain control following THA.

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The efficacy of periarticular drug infiltration for postoperative pain after total hip arthroplasty

Cited by 12 publications

References 20 publications

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

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

Comparing the efficacy of pain managements after total hip arthroplasty: A network meta‐analysis

How effective is periarticular drug infiltration in providing pain relief and early functional outcome following total hip arthroplasty?

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