局部注射包载布比卡因脂质体用于全膝关节置换术后镇痛并不优于传统关节周围注射：一项随机对照试验的荟萃分析。
Liposomal bupivacaine administration is not superior to traditional periarticular injection for postoperative pain management following total knee arthroplasty: a meta-analysis of randomized controlled trials.
机构信息
Department of Orthopedics, Taipei Veterans General Hospital, Taipei, Taiwan.
Department of Orthopedics, Taichung Veterans General Hospital, No.1650, Sec. 4, Taiwan Boulevard, Taichung, 40705, Taiwan.
出版信息
J Orthop Surg Res. 2023 Mar 16;18(1):206. doi: 10.1186/s13018-023-03699-4.
BACKGROUND
Liposomal bupivacaine (LB) is a relatively new formulation that slowly releases bupivacaine to extend its efficacy for 72-96 h. It is inconclusive whether LB offers better efficacy than traditional periarticular injection (TPAI) following total knee arthroplasty (TKA).
METHODS
Relevant randomized controlled trials (RCTs) were searched using electronic databases, including PubMed, Cochrane Library, EMBASE, and Web of Science. Review Manager 5.4.1 was used for calculations.
RESULTS
Sixteen RCTs were included in this meta-analysis. LB had better effects on morphine consumption equivalents during postoperative 24-48 h than TPAI. No significant difference was observed in pain relief, incidence of nausea and vomiting, or length of hospital stay between the two groups.
CONCLUSION
LB administration during TKA is not superior to TPAI. Studies with larger sample size are needed to validate our findings. PROSPERO registration number: CRD42022355094.
背景
脂质体布比卡因（LB）是一种新型制剂，它能缓慢释放布比卡因，将其疗效延长至 72-96 小时。LB 在全膝关节置换术后是否比传统关节周围注射（TPAI）更有效，目前尚无定论。
方法
使用电子数据库（包括 PubMed、Cochrane Library、EMBASE 和 Web of Science）搜索相关的随机对照试验（RCT）。使用 Review Manager 5.4.1 进行计算。
结果
本荟萃分析纳入了 16 项 RCT。LB 在术后 24-48 小时内的吗啡消耗量等效物方面优于 TPAI。两组间在疼痛缓解、恶心呕吐发生率或住院时间方面无显著差异。
结论
在 TKA 中使用 LB 并不优于 TPAI。需要更大样本量的研究来验证我们的发现。PROSPERO 注册号：CRD42022355094。
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