title: Local anesthetic infusion pump for pain management following total knee arthroplasty: a meta-analysis.
abstract: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) were to evaluate the effect and safety of local anesthetic infusion pump versus placebo for pain management following total knee arthroplasty (TKA).
  
  
  
  In September 2016, a systematic computer-based search was conducted in the Pubmed, ISI Web of Knowledge, Embase, Cochrane Database of Systematic Reviews. Randomized controlled trials of patients prepared for primary TKA that compared local anesthetic infusion pump versus placebo for pain management following TKA were retrieved. The primary endpoint was the visual analogue scale (VAS) with rest or mobilization at 24, 48 and 72 h and morphine consumption at 24 and 48 h. The second outcomes are range of motion, length of hospital stay (LOS) and complications (infection, deep venous thrombosis (DVT), prolonged drainage and postoperative nausea and vomiting (PONV)).
  
  
  
  Seven clinical studies with 587 patients were included and for meta-analysis. Local anesthetic infusion pump are associated with less pain scores with rest or mobilization at 24 and 48 h with significant difference. However, the difference was likely no clinical significance. There were no significant difference between the LOS, the occurrence of DVT, prolonged drainage and PONV. However, local anesthetic infusion pump may be associated with more infection.
  
  
  
  Based on the current meta-analysis, we found no evidence to support the routine use of local anesthetic infusion pump in the management of acute pain following TKA. More RCTs are still need to identify the pain control effects and optimal dose and speed of local anesthetic pain pump.
authors.affiliation: Department of Anesthesiology, the Affiliated Hospital of Hangzhou Normal University, 126 Wenzhou Road, Hangzhou, Zhejiang, 310015, China.
authors.forename: Yeying
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310005, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Lu
authors.affiliation: Department of anesthesiology, School of Medicine, Hangzhou Normal University, the affiliated Hospital of Hangzhou Normal University, 16 Xuelin St, Xiasha Higher Education Campus, Hangzhou, Zhejiang, 310036, China. scitougao007@qq.com.
authors.forename: Cheng
authors.initials: C
authors.lastname: Chang
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000639:trends; D006801:Humans; D007260:Infusion Pumps / Q000639:trends; D059408:Pain Management / Q000379:methods*; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D016032:Randomized Controlled Trials as Topic / Q000379:methods
chemical_list: D000779:Anesthetics, Local
keywords: Infusion pump; Local anesthesia; Meta-analysis; Total knee arthroplasty