Ma Ting-Ting, Wang Yu-Hui, Jiang Yun-Feng, Peng Cong-Bin, Yan Chao, Liu Zi-Gui, Xu Wei-Xing
Department of Anesthesiology Department of Pain Management, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang Province, China.
Medicine (Baltimore). 2017 Jun;96(25):e7190. doi: 10.1097/MD.0000000000007190.
In the past, the efficacy of local infiltration of liposomal bupivacaine for total hip arthroplasty (THA) patients was in debate. Therefore, this meta-analysis was conducted to determine whether local infiltration of liposomal bupivacaine provides better pain relief after THA.
We searched Web of Science, PubMed, Embase, and the Cochrane Library databases to the April 2017. Any studies comparing liposomal bupivacaine and traditional bupivacaine were included in our meta-analysis. The outcomes included visual analog scale (VAS) at 24, 48, and 72 hours, total morphine consumption at 24 hours, and the length of hospital stay. We assessed the pooled data using a random-effect model.
Six studies were finally included in this meta-analysis. Our pooled data analysis demonstrated that liposomal bupivacaine was more effective than the traditional bupivacaine in terms of VAS at 24 hours (P = .018) and the length of hospital stay (P = .000). There was no significant difference in terms of the VAS at 48 and 72 hours and total morphine consumption at 24 hours (P >.05).
Compared with the traditional bupivacaine, liposomal bupivacaine shows better pain control at 24 hours and reduces the length of hospital stay after THA. Its economic costs must be assessed in multimodal center randomized controlled trials when being recommended as a long-acting alternative analgesic agent for a THA patient.
过去,脂质体布比卡因局部浸润用于全髋关节置换术(THA)患者的疗效存在争议。因此,进行了这项荟萃分析,以确定脂质体布比卡因局部浸润在THA后是否能提供更好的疼痛缓解。
我们检索了截至2017年4月的Web of Science、PubMed、Embase和Cochrane图书馆数据库。任何比较脂质体布比卡因和传统布比卡因的研究都纳入我们的荟萃分析。结局指标包括24、48和72小时的视觉模拟评分(VAS)、24小时的吗啡总消耗量以及住院时间。我们使用随机效应模型评估汇总数据。
本荟萃分析最终纳入6项研究。我们的汇总数据分析表明,脂质体布比卡因在24小时VAS(P = 0.018)和住院时间(P = 0.000)方面比传统布比卡因更有效。在48和72小时的VAS以及24小时的吗啡总消耗量方面无显著差异(P>0.05)。
与传统布比卡因相比,脂质体布比卡因在24小时显示出更好的疼痛控制,并缩短了THA后的住院时间。在被推荐作为THA患者的长效替代镇痛药时,其经济成本必须在多模式中心随机对照试验中进行评估。