Yan Huan, Cang Jing, Xue Zhanggang, Lu Jianfeng, Wang Hao
Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, People's Republic of China.
Bosn J Basic Med Sci. 2016 Nov 10;16(4):239-246. doi: 10.17305/bjbms.2016.1072.
Pain management after total knee arthroplasty (TKA) and total hip arthroplasty should permit early mobilization with minimal pain. Local infiltration analgesia (LIA) is a new popular method for decreasing postoperative pain. The goal of this meta-analysis is to evaluate the efficacy of LIA in comparison with epidural analgesia. A literature search was performed in PubMed, EMBASE, the OVID database, Web of Science, and the Cochrane Library databases. The risk of bias was assessed using the Cochrane collaboration tool. Outcomes of interest included visual analog scale score, range of flexion, length of stay, and complications. Nine trials involving 537 patients met the inclusion criteria. LIA provides better pain relief and larger range of motion in TKA patients compared to epidural analgesia at the late postoperative period. No significant difference was observed in regard to the length of stay and complications. The current evidence shows that the use of local infiltration is effective for postoperative pain management in TKA patients. More high-quality randomized controlled trials with long-term follow-up are required for examining the long-term efficacy and safety of local infiltration.
全膝关节置换术（TKA）和全髋关节置换术后的疼痛管理应允许患者在疼痛最小的情况下尽早活动。局部浸润镇痛（LIA）是一种新的常用术后镇痛方法。本荟萃分析旨在评估LIA与硬膜外镇痛相比的疗效。在PubMed、EMBASE、OVID数据库、Web of Science和Cochrane图书馆数据库中进行了文献检索。使用Cochrane协作工具评估偏倚风险。感兴趣的结果包括视觉模拟量表评分、屈曲范围、住院时间和并发症。九项涉及537例患者的试验符合纳入标准。与硬膜外镇痛相比，LIA在TKA患者术后晚期能提供更好的疼痛缓解和更大范围活动度。在住院时间和并发症方面未观察到显著差异。目前的证据表明，局部浸润用于TKA患者术后疼痛管理是有效的。需要更多高质量的长期随访随机对照试验来检验局部浸润的长期疗效和安全性。
