Sun Hao, Huang Zhiyu, Zhang Zhiqi, Liao Weiming
Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
J Knee Surg. 2019 Mar;32(3):251-258. doi: 10.1055/s-0038-1641141. Epub 2018 Apr 4.
Liposomal bupivacaine is a novel method for pain control after total knee arthroplasty (TKA), but recent studies showed no advantage for patients undergoing TKA compared with traditional periarticular injection (PAI). The purpose of this analysis was to compare the clinical outcomes between liposomal bupivacaine treatment and traditional PAI. We retrospectively reviewed data from 16 clinical trials in published databases from their inception to June 2017. The primary outcome was postoperative Visual Analogue Scale (VAS) score and secondary outcomes included opiate usage, narcotic consumption, range of motion, and length of stay. Nine randomized controlled trials and seven nonrandomized controlled trials involving 924 liposomal bupivacaine cases and 1,293 traditional PAI cases were eligible for inclusion in the meta-analysis. No differences were detected in most of the clinical outcomes, except for postoperative VAS within 12 hours and length of stay. This analysis showed that liposomal bupivacaine is not associated with significant improvement in postoperative pain control or other outcomes in TKA compared with PAI.
脂质体布比卡因是全膝关节置换术（TKA）后控制疼痛的一种新方法，但最近的研究表明，与传统关节周围注射（PAI）相比，接受TKA的患者并无优势。本分析的目的是比较脂质体布比卡因治疗与传统PAI的临床结果。我们回顾性地查阅了已发表数据库中从开始到2017年6月的16项临床试验数据。主要结果是术后视觉模拟评分（VAS），次要结果包括阿片类药物使用情况、麻醉剂消耗量、活动范围和住院时间。9项随机对照试验和7项非随机对照试验，涉及924例脂质体布比卡因病例和1293例传统PAI病例，符合纳入荟萃分析的条件。除术后12小时内的VAS和住院时间外，大多数临床结果未发现差异。该分析表明，与PAI相比，脂质体布比卡因与TKA术后疼痛控制或其他结果的显著改善无关。
