The efficacy of local liposomal bupivacaine infiltration on pain and recovery after Total Joint Arthroplasty: A systematic review and meta-analysis of randomized controlled trials

Baocheng Zhao, Xinlong Ma, Jinli Zhang, Jianxiong Ma, Qing Cao, Baocheng Zhao, Xinlong Ma, Jinli Zhang, Jianxiong Ma, Qing Cao

Abstract

Background: Total Joint Arthroplasty (TJA) is gradually emerging as the treatment of choice for end-stage osteoarthritis. In the past, Perioperative liposomal bupivacaine treatment is still a controversial subject in TJA. Therefore, we write this systematic review and meta-analysis to evaluate the efficacy of liposomal bupivacaine on pain and recovery after TJA.

Materials and methods: Embase, Pubmed, and Cochrane Library were comprehensively searched. Randomized controlled trials (RCTs), cohort studies were included in our meta-analysis. Twelve studies that compared liposomal bupivacaine groups with placebo groups were included in our meta-analysis. The research was reported according to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. RCTs were included in our meta-analysis.

Results: Our study demonstrated that liposomal bupivacaine group was as effective as the placebo group in term of VAS score at 24 h (P = .09), 48 h (P = .97); Postoperative nausea (P = .72); and LOS (0.27). There was significant difference in terms of total morphine consumption at 24 h (P < .0001), 48 h (P = .0008).

Conclusion: Our meta-analysis demonstrated that liposomal bupivacaine has similar pain control and functional recovery after TJA which compared with the control group. However, we still need large sample size, high-quality studies to explore the relationship between complications and dose response to give the final conclusion.

Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Search results and the selection procedure.
Figure 2
Figure 2
Methodological quality of the randomized controlled trials.
Figure 3
Figure 3
Risk of bias.
Figure 4
Figure 4
VAS score at 24 h after TJA. TJA = Total Joint Arthroplasty, VAS = visual analogue scale.
Figure 5
Figure 5
VAS score at 48 h after TJA. TJA = Total Joint Arthroplasty, VAS = visual analogue scale.
Figure 6
Figure 6
Opioid consumption at 24 h after TJA. TJA = Total Joint Arthroplasty.
Figure 7
Figure 7
Opioid consumption at 48 h after TJA. TJA = Total Joint Arthroplasty.
Figure 8
Figure 8
The incidence of nausea after TJA. TJA = Total Joint Arthroplasty.
Figure 9
Figure 9
Length of hospital stay after TJA. TJA = Total Joint Arthroplasty.

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Source: PubMed

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