Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.
Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
BMC Musculoskelet Disord. 2019 Jun 1;20(1):269. doi: 10.1186/s12891-019-2628-7.
Periarticular 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.
We 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.
Our 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).
Compared 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.
关节周围注射（PAI）是全髋关节置换术（THA）中一种用于术后缓解疼痛的区域镇痛方法。然而，其疗效和安全性仍不确定。因此，我们进行了这项荟萃分析，以评估 PAI 的安全性，并确定 PAI 是否能提供更好的疼痛缓解效果并减少 THA 后的阿片类药物消耗。
我们全面检索了 PubMed、Web of Science、Embase 和 Cochrane Library。我们的荟萃分析仅纳入了随机对照试验。共纳入了 11 项比较 PAI 与对照组疗效的研究。我们应用系统评价和荟萃分析的首选报告项目（PRISMA）指南和 Jadad 评分来评估纳入研究的质量。我们按照 Cochrane 协作组织的建议来降低偏倚，确保我们的结果可靠且真实。
我们的分析表明，与对照组相比，PAI 在术后 24 小时静息时（P=0.003）、48 小时（P=0.002）和活动时（P=0.04）的视觉模拟评分（VAS）更低，镇痛效果更好。阿片类药物的消耗量也更少（P=0.01）。两组的住院时间（P=0.526）和术后恶心发生率（P=0.153）无差异。
与对照组相比，PAI 可提供更好的 THA 术后疼痛缓解效果，并减少阿片类药物的使用量。我们的荟萃分析表明，PAI 是一种安全有效的多模式镇痛技术，可用于 THA。
