title: Comparison of peri-articular liposomal bupivacaine and standard bupivacaine for postsurgical analgesia in total knee arthroplasty: A systematic review and meta-analysis.
abstract: OBJECTIVE
  This meta-analysis aimed to compare the efficacy and safety of intraoperative peri-articular liposomal bupivacaine and standard bupivacaine in patients undergoing total knee arthroplasty.
  
  
  METHODS
  A systematic search was performed in Medline (1966-2016.9), PubMed (1966-2016.9), Embase (1980-2016.9), ScienceDirect (1985-2016.9) and the Cochrane Library. Only high-quality studies were selected. Meta-analysis was performed using Stata 11.0 software.
  
  
  RESULTS
  Three randomized controlled trials (RCTs) and two non-randomized controlled trials (Non-RCTs), including 1214 patients met the inclusion criteria. The present meta-analysis indicated that there were significant differences between groups in terms of visual analogue scale (VAS) score at 24 h (SMD = -0.241, 95% CI: -0.374 to -0.108, P = 0.000), VAS score at 48 h (SMD = -0.124, 95% CI: -0.256 to 0.009, P = 0.0068), morphine equivalent consumption on POD 1 (SMD = -0.275, 95% CI: -0.398 to -0.153, P = 0.000) and incidence of nausea (RD = 0.038, 95% CI: 0.001 to 0.074, P = 0.042) and vomiting (RD = 0.38, 95% CI: 0.003 to 0.072, P = 0.032).
  
  
  CONCLUSIONS
  Compared to standard bupivacaine, intraoperative peri-articular liposomal bupivacaine infiltration promotes superior pain relief and less morphine consumption after total knee arthroplasty. In addition, there were fewer side effects associated with liposomal bupivacaine infiltration.
authors.affiliation: Joint Surgery, Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, 710054, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Wang
authors.affiliation: Joint Surgery, Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, 710054, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Xiao
authors.affiliation: Joint Surgery, Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, 710054, China.
authors.forename: Zhiyuan
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Joint Surgery, Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, 710054, China.
authors.forename: Guanghui
authors.initials: G
authors.lastname: Zhao
authors.affiliation: Joint Surgery, Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, 710054, China. Electronic address: 3483245892@qq.com.
authors.forename: Jianbing
authors.initials: J
authors.lastname: Ma
mesh_terms: D000698:Analgesia / Q000009:adverse effects / Q000379:methods; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D002045:Bupivacaine / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D006801:Humans; D007270:Injections, Intra-Articular; D008081:Liposomes; D009020:Morphine / Q000008:administration & dosage; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D008081:Liposomes; D009020:Morphine; D002045:Bupivacaine
keywords: Liposomal bupivacaine; Meta-analysis; Pain control; Standard bupivacaine; Total knee arthroplasty