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Local infiltration anesthesia versus epidural analgesia for postoperative pain control in total knee arthroplasty: a systematic review and meta-analysis.

ABSTRACT: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of local infiltration anesthesia (LIA) versus epidural analgesia (EPA) for postoperative pain control in total knee arthroplasty (TKA).In December 2017, a systematic computer-based search was conducted in Pubmed, EMBASE, Web of Science, and Cochrane Database of Systematic Reviews. RCTs of patients prepared for spine surgery that compared LIA versus EPA for postoperative pain control in TKA were retrieved. The primary endpoint was the VAS score with rest or mobilization at 12, 24 and 48, and 72 h. The secondary outcomes were the range of motion, the length of stay, and the occurrence of infection and nausea. After testing for publication bias and heterogeneity between studies, data were aggregated for random-effects models when necessary.Seven clinical studies with 251 patients (LIA = 124, EPA = 127) were included in the meta-analysis. There was no significant difference between LIA and EPA group in terms of the VAS score with rest at 12 and 24 h. LIA was associated with a reduction of the VAS score with rest at 48 and 72 h than EPA (P??0.05). And LIA was associated with an increase of the range of motion at 24 and 48 h (P?

SUBMITTER: Li C

PROVIDER: S-EPMC5956819 | biostudies-other | 2018 May

REPOSITORIES: biostudies-other

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Local infiltration anesthesia versus epidural analgesia for postoperative pain control in total knee arthroplasty: a systematic review and meta-analysis.

Li Chen C Qu Ji J Pan Su S Qu Yang Y

Journal of orthopaedic surgery and research 20180516 1

<h4>Background</h4>We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of local infiltration anesthesia (LIA) versus epidural analgesia (EPA) for postoperative pain control in total knee arthroplasty (TKA).<h4>Methods</h4>In December 2017, a systematic computer-based search was conducted in Pubmed, EMBASE, Web of Science, and Cochrane Database of Systematic Reviews. RCTs of patients prepared for spine surgery that compared ...[more]

PMID: 29769140

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Project description:BackgroundLocal infiltration anesthesia (LIA) and femoral nerve block (FNB) are commonly used analgesia methods after total knee arthroplasty (TKA). However, there is no definitive conclusion about which of these two analgesia modes is superior. Therefore, this study aimed to systematically evaluate the analgesic effects of LIA and FNB after TKA.MethodsWe used the terms "total knee replacement, knee replacement, total knee arthroplasty, knee arthroplasty, local infiltration analgesia, periarticular infiltration, periarticular injection, intra-articular infiltration, intra-articular injection, peripheral nerve block, femoral nerve block" to search the PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu databases. The search period was set from the date of establishment of the database to September 2021. The Cochrane risk of bias tool was used to evaluate the quality of the included studies, and network meta-analysis was performed using Stata14.0 and RevMan 5.30 software.ResultsNine articles were included for analysis. The results of meta-analysis showed that compared with LIA and FNB, the difference in opioid use [mean difference (MD) -4.35, 95% confidence interval (CI): -7.26 to -1.45] was statistically significant. However, there was no significant difference between the static visual analogue score at 24 hours postoperatively (MD 0.20, 95% CI: -0.91 to 1.31), the visual analogue score for exercise visual analogy at 24 hours after surgery (MD 0.10, 95% CI: -0.12 to 0.32), and the length of hospital stay (MD 0.05, 95% CI: -0.40 to 0.50).DiscussionLIA and FNB have similar effects on pain relief after TKA, but LIA can reduce the use of analgesic drugs and is easy to operate. Therefore, LIA can be used as the priority analgesic method for patients with TKA. However, multi-center, large-sample, high-quality, randomized controlled trials are still needed for further verification.

Dataset Information

Local infiltration anesthesia versus epidural analgesia for postoperative pain control in total knee arthroplasty: a systematic review and meta-analysis.

Publications

Local infiltration anesthesia versus epidural analgesia for postoperative pain control in total knee arthroplasty: a systematic review and meta-analysis.

Similar Datasets

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