Abstract
BackgroundPeriarticular 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.MethodsWe 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.ResultsOur 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).ConclusionCompared 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.
Highlights
Periarticular injection (PAI) is a regional analgesia method performed in total hip arthroplasty (THA) for postoperative pain relief
Search results We identified 602 relevant articles according to the search strategy
11 articles that compared the efficacy of periarticular injection in THA with those without were included for our meta-analysis
Summary
Periarticular injection (PAI) is a regional analgesia method performed in total hip arthroplasty (THA) for postoperative pain relief. Its efficacy and safety is still inconclusive We conducted this metaanalysis to assess the safety of PAI and to determine if PAI provides better pain relief and reduce the consumption of opioids after THA. Periarticular injection (PAI) ( known as local infiltration analgesia or periarticular multimodal drug injection) is a new, alternative regional analgesic that involves administering analgesics into the surrounding tissue in the surgical field. This method usually consists of a local anesthetics of amide derivatives (eg, ropivacaine, bupivacaine, levobupivacaine, ropivacaine) and/or corticosteroids, opioids, epinephrine, nonsteroidal anti-inflammatory drugs. The present meta-analysis was conducted to determine the efficacy of PAI as a postoperative pain management in patients who had undergone THA surgery
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