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Meta-Analysis
. 2019 Jun 29;20(1):306.
doi: 10.1186/s12891-019-2660-7.

The efficacy of liposomal bupivacaine compared with traditional peri-articular injection for pain control following total knee arthroplasty: an updated meta-analysis of randomized controlled trials

Yuan Liu  1 , Yi Zeng  1 , Junfeng Zeng  1 , Mingyang Li  1 , Wenxing Wei  1 , Bin Shen  2
Affiliations
Meta-Analysis

The efficacy of liposomal bupivacaine compared with traditional peri-articular injection for pain control following total knee arthroplasty: an updated meta-analysis of randomized controlled trials

Yuan Liu et al. BMC Musculoskelet Disord. .

Abstract

Background: The efficacy of postoperative pain management is an important factor that influences the final outcome of total knee arthroplasty (TKA). Whether liposomal bupivacaine offers better efficacy compared with traditional peri-articular injection after TKA remains inconclusive. We conduct this study to compare the true efficacy of liposomal bupivacaine (LB) with traditional peri-articular injection (TPAI) following TKA.

Materials and methods: Randomized controlled trials (RCTs) from PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) and Web of Science were searched. Thirteen RCTs involving 1373 patients were finally included in our meta-analysis (LB = 691, TPAI = 682). The continuous and dichotomous outcome were collected in a standard form, and the data were analysed by using Review Manager 5.3 software. Finally, the results were presented in the forest plots.

Result: The pooled data demonstrated that the postoperative visual analogue score (VAS) in the LB group was not significantly different compared with that in the TPAI group at every time period after TKA. The liposomal bupivacaine group had significantly lower consumption of morphine equivalents 24 to 72 h postoperatively and reduced incidence of nausea and vomiting after TKA compared with the TPAI group. Finally, the length of hospital stay in the two groups was not significantly different.

Conclusion: Liposomal bupivacaine did not yield different results on the visual analogue scale compared with traditional peri-articular injection after total knee arthroplasty. However, liposomal bupivacaine was preferred in terms of lower consumption of morphine equivalents 24-72 h postoperatively and lower incidence of nausea and vomiting after total knee arthroplasty.

Keywords: Liposomal bupivacaine; Meta-analysis; Pain control; Randomized controlled trial; Total knee arthroplasty; Traditional peri-articular injection.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow of search results and selection procedure
Fig. 2
Fig. 2
Methodological quality of included studies
Fig. 3
Fig. 3
Risk of bias assessment of included studies
Fig. 4
Fig. 4
The frost plot of the VAS during the first 24 h after TKA
Fig. 5
Fig. 5
The frost plot of the VAS during the second 24 h after TKA
Fig. 6
Fig. 6
The frost plot of the VAS during the third 24 h after TKA
Fig. 7
Fig. 7
The frost plot of consumption of the morphine equivalents during the hospital stay
Fig. 8
Fig. 8
The frost plot of the incidence of nausea and vomiting after the TKA
Fig. 9
Fig. 9
The frost plot of the length of hospital stay
See this image and copyright information in PMC

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