Periarticular local anaesthetic in knee arthroplasty A systematic review and meta-analysis of randomised trials

• Published in: SA orthopaedic journal Vol. 15; no. 3; p. 49
• Main Authors: Gibbins, M L, Kane, C, Smit, R W, Rodseth, R N
• Format: Journal Article
• Language: English
• Published: Johannesburg Medpharm Publications 01.01.2016
• Subjects: Analgesics; Joint replacement surgery; Joint surgery; Local anesthesia; Meta-analysis; Systematic review
• ISSN: 1681-150X; 2309-8309
• DOI: 10.17159/2309-8309/2016/v15n3a7

BACKGROUND: This systematic review and meta-analysis aimed to quantify the effect of adding peri-articular local anaesthetic infiltration or infusion to an analgesic strategy in patients undergoing knee arthroplasty. METHODS: A literature search of six data bases was performed. Randomised controlled trials comparing periarticular local anaesthetic infiltration/infusion against other analgesic strategies in adult patients undergoing knee arthroplasty were included. The primary outcome was resting Visual Analogue Scores 24 hours after surgery. RESULTS: In the review, 396 potential studies were identified, of which 35 full text articles were assessed for eligibility. A total of 770 patients from 12 trials were included in the final meta-analysis. Local anaesthetic addition significantly improved pain control (mean difference -0.95 [95% CI -1.68 to -0.21]); however, there was significant heterogeneity (I2: 88%). CONCLUSION: Our analysis suggests that peri-articular local anaesthetic infiltration/infusion improves resting pain scores 24 hours after knee arthroplasty. However, the heterogeneity of these findings urges caution in their interpretation.