BACKGROUND:In the past, the efficacy of local infiltration of liposomal bupivacaine for total hip arthroplasty (THA) patients was in debate. Therefore, this meta-analysis was conducted to determine whether local infiltration of liposomal bupivacaine provides better pain relief after THA. METHODS:We searched Web of Science, PubMed, Embase, and the Cochrane Library databases to the April 2017. Any studies comparing liposomal bupivacaine and traditional bupivacaine were included in our meta-analysis. The outcomes included visual analog scale (VAS) at 24, 48, and 72 hours, total morphine consumption at 24 hours, and the length of hospital stay. We assessed the pooled data using a random-effect model. RESULTS:Six studies were finally included in this meta-analysis. Our pooled data analysis demonstrated that liposomal bupivacaine was more effective than the traditional bupivacaine in terms of VAS at 24 hours (P  =  .018) and the length of hospital stay (P  =  .000). There was no significant difference in terms of the VAS at 48 and 72 hours and total morphine consumption at 24 hours (P >.05). CONCLUSION:Compared with the traditional bupivacaine, liposomal bupivacaine shows better pain control at 24 hours and reduces the length of hospital stay after THA. Its economic costs must be assessed in multimodal center randomized controlled trials when being recommended as a long-acting alternative analgesic agent for a THA patient.

译文

背景:过去,脂质体布比卡因局部浸润对全髋关节置换术(THA)患者的疗效一直存在争议。因此,进行了这项荟萃分析,以确定脂质体布比卡因的局部浸润是否可以在THA后更好地缓解疼痛。
方法:我们搜索了Web of Science,PubMed,Embase和Cochrane图书馆数据库,直至2017年4月。我们对荟萃分析中所有比较脂质体布比卡因和传统布比卡因的研究都包括在内。结果包括24、48和72小时时的视觉模拟量表(VAS),24小时时的总吗啡消耗量以及住院时间。我们使用随机效应模型评估了汇总数据。
结果:该荟萃分析最终包括六项研究。我们的汇总数据分析表明,脂质体布比卡因在24小时时的VAS(P than = .018)和住院时间(P = .000)方面比传统布比卡因更有效。在48和72小时时的VAS和24小时时的总吗啡消耗量方面无显着差异(P> .05)。
结论:与传统布比卡因相比,脂质体布比卡因在24小时可更好地控制疼痛,并缩短THA后的住院时间。当被推荐作为THA患者的长效替代镇痛药时,必须在多模式中心随机对照试验中评估其经济成本。

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