Abstract

GIBBINS, ML; KANE, C; SMIT, RW  and  RODSETH, RN. Periarticular local anaesthetic in knee arthroplasty: A systematic review and meta-analysis of randomised trials. SA orthop. j. [online]. 2016, vol.15, n.3, pp.49-56. ISSN 2309-8309.  http://dx.doi.org/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.

Keywords : local anaesthetic; arthroplasty; knee arthroplasty; knee replacement; intra-articular injections.

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