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Intrathecal versus local infiltration analgesia for pain control in total joint arthroplasty

Authors
  • Cai, Ai-Lan1
  • Liu, Sheng-Jie1
  • Wu, Bin1
  • Liu, Geng1
  • 1 Liaocheng People’s Hospital, No.67 DongChang West Road, Liaocheng, Shandong, 252000, China , Liaocheng (China)
Type
Published Article
Journal
Journal of Orthopaedic Surgery and Research
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Mar 18, 2020
Volume
15
Issue
1
Identifiers
DOI: 10.1186/s13018-020-01627-4
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundThe purpose of this meta-analysis was to assess the efficacy of intrathecal morphine (ITM) analgesia and local infiltration analgesia (LIA) for pain control in total joint arthroplasty (TJA).MethodsEmbase, PubMed, the Cochrane Library, and Web of Science were systematically searched for randomized controlled trials (RCTs). All RCTs were comparing intrathecal analgesia and local infiltration analgesia in TJA. Primary outcomes were the visual analog scale (VAS) score with rest or mobilization up to 72 h. Secondary outcomes were the total morphine consumption, length of hospital stay, and morphine-related complications.ResultsCompared with the intrathecal analgesia group, the LIA group was associated with a reduction in VAS score with rest up to 72 h. Moreover, LIA was associated with a decrease in VAS score with mobilization at 6 h, 12 h, 48 h, and 72 h. Moreover, LIA significantly reduced total morphine consumption (weighted mean difference (WMD) = − 15.37, 95% CI − 22.64 to − 8.83, P = 0.000), length of hospital stay (WMD = − 1.39, 95% CI − 1.67 to − 1.11, P = 0.000), and morphine-related complications (nausea and pruritus).ConclusionsLocal infiltration provided superior analgesia and morphine-sparing effects within the first 72 h compared with ITM following TJA.

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