Efficacy and safety of single-dose local infiltration of analgesia in total knee arthroplasty: A meta-analysis of randomized controlled trials

Xu, Changpeng; Li, Xue; Wang, Zhizhong; Song, Jingyu; Yu, Bin

doi:10.1016/j.knee.2014.02.024

Cited by 35 publications

(24 citation statements)

References 43 publications

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“…Likely reasons are that blood transfusions can take several hours, which delays mobilisation, and that patients requiring transfusion are unlikely to mobilise due to severe symptomatic anaemia. LIA should theoretically assist with full-weight bearing post-operatively, as a systematic review and meta-analyses reported that LIA improves early analgesia after THA or TKA in the 48-hour post-operative period [25, 26]. However, we found no significant association between LIA and our outcomes on multivariate analysis.…”

Section: Discussioncontrasting

confidence: 57%

Early mobilisation after total hip or knee arthroplasty: A multicentre prospective observational study

et al. 2017

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ObjectiveEarly mobilisation is recommended following total hip arthroplasty (THA) or total knee arthroplasty (TKA) to prevent venous thromboembolism (VTE). We sought to determine the proportions of patients that first mobilised on post-operative day 0 (POD 0) and factors associated with earlier time to mobilisation.MethodsA prospective cohort study was conducted involving patients with hip or knee osteoarthritis who had undergone primary unilateral THA (n = 818) and TKA (n = 989) at 19 Australian hospitals. Patient-related (e.g. age, gender, body mass index), treatment-related (e.g. hospital site, presence of indwelling catheter) and mobilisation-related variables were collected on standardised forms. Time was measured by post-operative days, where POD 0 was defined as the day of surgery ending at midnight. Multivariate Poisson regression analysis identified associations between patient- and treatment-related covariates and time to mobilisation.ResultsInter-hospital variation was evident, but overall, only 9.4% of THA and 5.6% of TKA patients mobilised on POD 0. For THA patients, earlier time to mobilisation was associated with hospital site and absences of an indwelling catheter and acute complications. For TKA patients, earlier time to mobilisation was associated with hospital site and absence of donor blood transfusion.ConclusionsFew THA and TKA patients mobilise POD 0, although some hospitals appear more aggressive with their mobilisation attempts than others. Treatment-related factors, not patient-related, are associated with post-operative day of mobilisation, indicating the potentially pivotal role of service providers in promoting early mobilisation to improve health outcomes and reduce rates of VTE.

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Section: Discussioncontrasting

confidence: 57%

Early mobilisation after total hip or knee arthroplasty: A multicentre prospective observational study

et al. 2017

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“…respiratory depression, and urinary retention. 1 Thus, LIA has become increasingly popular for its potential to avoid these complications.…”

Section: Implications For Clinical Practice or Policymentioning

confidence: 99%

Local infiltration analgesia in primary total knee arthroplasty

Fang¹,

Lee²,

Chang³

et al. 2019

Hong Kong Med J

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Postoperative pain in total knee arthroplasty (TKA) can hinder rehabilitation and cause morbidity. Local infiltration analgesia (LIA), comprising an anaesthetic drug, non-steroidal anti-inflammatory drug, and adrenaline, has been introduced to reduce pain and systemic side-effects. This study evaluated the efficacy of LIA in TKA with respect to morphine consumption and postoperative pain score. Methods: This single-centre retrospective cohort study recruited patients with knee osteoarthritis who were scheduled for primary TKA during the period from January 2017 to December 2017. Patients with chronic inflammatory joint disease, contra-indications for LIA, or dementia were excluded. Patients in the LIA group were administered single-dose LIA intra-operatively, while those in the control group were not. Primary outcomes were postoperative pain score, morphine demand, and morphine consumption; secondary outcomes were range of motion, quadriceps power, and postoperative length of stay. Results: In total, 136 patients were recruited (68 per group). Total postoperative morphine demand

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“…Periarticular injections (PAI) or local infiltration is an analgesic technique which involves the injection of analgesic drugs into injured tissue such as the synovium, joint capsule, and subcutaneous tissues during TKA 68,69 . It was designed to specifically avoid sedation, facilitate rapid physiological recovery, and to enable early mobilization and discharge by not compromising muscle tone 5,70,71 .…”

Section: Periarticular Injectionsmentioning

confidence: 99%

“…However, the placement of a catheter in continuous infusions allows for prolonged site-specific regional analgesia which may be beneficial 16 . By contrast, single injection PAI is common in clinical practice and reported to be inexpensive and relatively easy to perform and have fewer side effects 69 .…”

Section: Periarticular Injectionsmentioning

confidence: 99%

Ultrasound-Guided Motor-Sparing Knee Blocks for Postoperative Analgesia Following Total Knee Arthroplasty

Sogbein

Sondekoppam

Bryant

et al. 2017

The Journal of Bone and Joint Surgery

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Efficacy and safety of single-dose local infiltration of analgesia in total knee arthroplasty: A meta-analysis of randomized controlled trials

Cited by 35 publications

References 43 publications

Early mobilisation after total hip or knee arthroplasty: A multicentre prospective observational study

Early mobilisation after total hip or knee arthroplasty: A multicentre prospective observational study

Local infiltration analgesia in primary total knee arthroplasty

Ultrasound-Guided Motor-Sparing Knee Blocks for Postoperative Analgesia Following Total Knee Arthroplasty

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