caa a22 4500 605457255 CHVBK 20210128100222.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s00167-013-2788-1 doi (NATIONALLICENCE)springer-10.1007/s00167-013-2788-1 Local infiltration analgesia following total knee arthroplasty: effect on post-operative pain and opioid consumption—a meta-analysis [Elektronische Daten] [Renée Keijsers, Rogier van Delft, Michel van den Bekerom, Dirk de Vries, Richard Brohet, Peter Nolte] Introduction: Local infiltration analgesia (LIA) is a popular method for decreasing post-operative pain after total knee arthroplasty (TKA). The goal of this meta-analysis is to compare the effect of LIA with placebo on the intensity of post-operative pain and the consumption of opioids. Methods: A search was performed in the PubMed/MEDLINE, Cochrane, EMBASE and TRIP databases. All (quasi)-randomized controlled trials (RCTs) were included. LIA consists of intra-operative infiltration with at least one analgesic component. Data were pooled using Cochrane software. Results: Seven placebo-controlled RCTs were included, involving 405 TKAs. On the first post-operative day, LIA provides an average decrease in VAS scores at rest of 12.3% compared to placebo. Six RCTs studied opioid consumption in patients following TKA. There was a decrease in opioid consumption of 14.8% compared to placebo 24h after surgery. This suggests a reduced pain perception due to LIA. On the second post-operative day, the effect on both outcome measures was diminished and no longer significant. Heterogeneity between the studies was 71% for pain and 39% for opioid consumption (p=0.002 and p=0.0005). No major complications were reported with the use of LIA. Conclusion: LIA might be able to decrease pain and the use of opioids on the first post-operative day following TKA. However, due to the high level of heterogeneity between the studies, no firm conclusions can be drawn. Level of evidence: Meta-analysis, Level II. Springer-Verlag Berlin Heidelberg, 2013 Knee arthroplasty nationallicence Analgesia nationallicence Post-operative pain nationallicence Meta-analysis nationallicence Keijsers Renée Department of Orthopaedic Surgery, Spaarne Hospital, P.O. Box 770, 2130 AT, Hoofddorp, The Netherlands aut van Delft Rogier Departement of Anesthesiology, Leids Universitair Medisch Centrum, P.O.Box 9600, 2300RC, Leiden, The Netherlands aut van den Bekerom Michel Department of Orthopaedic Surgery, O.L.V.G., P.O. Box 95500, 1090 HM, Amsterdam, The Netherlands aut de Vries Dirk Department of Anesthesiology, Spaarne Hospital, P.O. Box 770, 2130 AT, Hoofddorp, The Netherlands aut Brohet Richard Research Center Linnaeus Insititute, Spaarne Hospital, P.O. Box 770, 2130 AT, Hoofddorp, The Netherlands aut Nolte Peter Department of Orthopaedic Surgery, Spaarne Hospital, P.O. Box 770, 2130 AT, Hoofddorp, The Netherlands aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/7(2015-07-01), 1956-1963 0942-2056 23:7<1956 2015 23 167 https://doi.org/10.1007/s00167-013-2788-1 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 review-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-013-2788-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Keijsers Renée Department of Orthopaedic Surgery, Spaarne Hospital, P.O. Box 770, 2130 AT, Hoofddorp, The Netherlands aut NATIONALLICENCE 700 1- van Delft Rogier Departement of Anesthesiology, Leids Universitair Medisch Centrum, P.O.Box 9600, 2300RC, Leiden, The Netherlands aut NATIONALLICENCE 700 1- van den Bekerom Michel Department of Orthopaedic Surgery, O.L.V.G., P.O. Box 95500, 1090 HM, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- de Vries Dirk Department of Anesthesiology, Spaarne Hospital, P.O. Box 770, 2130 AT, Hoofddorp, The Netherlands aut NATIONALLICENCE 700 1- Brohet Richard Research Center Linnaeus Insititute, Spaarne Hospital, P.O. Box 770, 2130 AT, Hoofddorp, The Netherlands aut NATIONALLICENCE 700 1- Nolte Peter Department of Orthopaedic Surgery, Spaarne Hospital, P.O. Box 770, 2130 AT, Hoofddorp, The Netherlands aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/7(2015-07-01), 1956-1963 0942-2056 23:7<1956 2015 23 167