title: Intra-articular bupivacaine after joint arthroplasty: a systematic review and meta-analysis of randomised placebo-controlled studies.
abstract: To evaluate the efficacy and safety of intra-articular (IA) bupivacaine administered for pain relief after joint arthroplasty.
  
  
  
  Meta-analysis.
  
  
  
  A systematic review was conducted to identify the randomised controlled trials using IA bupivacaine for postoperative pain relief from MEDLINE, Cochrane Library and EMBASE databases (up to October 2015). The standardised mean difference (SMD), the relative risk (RR) and their corresponding 95% CIs were calculated using the RevMan statistical software.
  
  
  
  A total of 11 randomised controlled trials were included. Statistically significant differences between IA bupivacaine and placebo were observed for the mean visual analogue scale (VAS) values (SMD -0.55; 95% CI -0.89 to -0.22; p<0.001) and narcotic consumption (SMD -0.32; 95% CI -0.55 to -0.08; p=0.008) during the period of 24 hours postoperatively and narcotic consumption during the period between 24 and 48 hours postoperatively (SMD -0.32; 95% CI -0.55 to -0.08; p=0.009). However, there was no significant difference in the mean VAS pain score during the period between 24  and 48 hours postoperatively (SMD -0.09, 95% CI -0.30 to 0.11; p=0.37) and in the incidence of adverse effects 24-72 hours postoperatively (RR 0.97; 95% CI 0.60 to 1.57; p=0.91).
  
  
  
  The administration of IA bupivacaine after joint arthroplasty is effective for pain relief without increasing adverse effects.
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Cui
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Tuo
authors.initials: T
authors.lastname: Yang
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Zeng
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Wei
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Xie
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Liangjun
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Ding
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Guanghua
authors.initials: G
authors.lastname: Lei
mesh_terms: D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D001178:Arthroplasty / Q000009:adverse effects*; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use*; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000601:surgery*; D009294:Narcotics / Q000627:therapeutic use; D059408:Pain Management; D010149:Postoperative Pain / Q000188:drug therapy*
chemical_list: D000700:Analgesics; D009294:Narcotics; D002045:Bupivacaine
keywords: Analgesics; Intra-articular; PAIN MANAGEMENT