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Liposomal bupivacaine versus interscalene nerve block for pain control after shoulder arthroplasty: A meta-analysis
BACKGROUND: Postoperative pain control after total shoulder arthroplasty (TSA) can be challenging. Liposomal bupivacaine and interscalene nerve block are 2 common pain control protocol for TSA patients. However, whether liposomal bupivacaine was superior than interscalene nerve block was unknown. Th...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Wolters Kluwer Health
2017
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5502145/ https://www.ncbi.nlm.nih.gov/pubmed/28682872 http://dx.doi.org/10.1097/MD.0000000000007226 |
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author | Yan, Zeng Chen, Zong Ma, Chuangen |
author_facet | Yan, Zeng Chen, Zong Ma, Chuangen |
author_sort | Yan, Zeng |
collection | PubMed |
description | BACKGROUND: Postoperative pain control after total shoulder arthroplasty (TSA) can be challenging. Liposomal bupivacaine and interscalene nerve block are 2 common pain control protocol for TSA patients. However, whether liposomal bupivacaine was superior than interscalene nerve block was unknown. This meta-analysis aimed to illustrate the efficacy liposomal bupivacaine versus interscalene nerve block for pain control in patients undergoing TSA. METHODS: In May 2017, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, Cochrane Database of Systematic Reviews, and Google database. Data on patients prepared for TSA in studies that compared liposomal bupivacaine versus interscalene nerve block were retrieved. The endpoints were the visual analogue scale (VAS) at 4 hours, 8 hours, 12 hours, 24 hours, and 2 weeks, total morphine consumption at 24 hours, and the length of hospital stay. Software of Stata 12.0 was used for pooling the final outcomes. RESULTS: Five clinical studies with 573 patients (liposomal bupivacaine group = 239, interscalene nerve block group = 334) were ultimately included in the meta-analysis. There was no significant difference between the VAS at 4 hours, 8 hours, and 2 weeks between liposomal bupivacaine group and interscalene nerve block group (P > .05). Compared with interscalene nerve block group, liposomal bupivacaine was associated with a reduction of VAS score at 12 hours, 24 hours by appropriately 3.31 points and 6.42 points respectively on a 100-point VAS. Furthermore, liposomal bupivacaine was associated with a significantly reduction of the length of hospital stay by appropriately by 0.16 days compared with interscalene nerve block group. CONCLUSION: Current meta-analysis indicates that compared with interscalene nerve block, liposomal bupivacaine had comparative effectiveness on reducing both pain scores and the length of hospital stay. However, studies with more patients and better-designed methods are needed to establish the optimal regimen and the safety of liposomal bupivacaine in TSA patients. |
format | Online Article Text |
id | pubmed-5502145 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-55021452017-07-18 Liposomal bupivacaine versus interscalene nerve block for pain control after shoulder arthroplasty: A meta-analysis Yan, Zeng Chen, Zong Ma, Chuangen Medicine (Baltimore) 7100 BACKGROUND: Postoperative pain control after total shoulder arthroplasty (TSA) can be challenging. Liposomal bupivacaine and interscalene nerve block are 2 common pain control protocol for TSA patients. However, whether liposomal bupivacaine was superior than interscalene nerve block was unknown. This meta-analysis aimed to illustrate the efficacy liposomal bupivacaine versus interscalene nerve block for pain control in patients undergoing TSA. METHODS: In May 2017, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, Cochrane Database of Systematic Reviews, and Google database. Data on patients prepared for TSA in studies that compared liposomal bupivacaine versus interscalene nerve block were retrieved. The endpoints were the visual analogue scale (VAS) at 4 hours, 8 hours, 12 hours, 24 hours, and 2 weeks, total morphine consumption at 24 hours, and the length of hospital stay. Software of Stata 12.0 was used for pooling the final outcomes. RESULTS: Five clinical studies with 573 patients (liposomal bupivacaine group = 239, interscalene nerve block group = 334) were ultimately included in the meta-analysis. There was no significant difference between the VAS at 4 hours, 8 hours, and 2 weeks between liposomal bupivacaine group and interscalene nerve block group (P > .05). Compared with interscalene nerve block group, liposomal bupivacaine was associated with a reduction of VAS score at 12 hours, 24 hours by appropriately 3.31 points and 6.42 points respectively on a 100-point VAS. Furthermore, liposomal bupivacaine was associated with a significantly reduction of the length of hospital stay by appropriately by 0.16 days compared with interscalene nerve block group. CONCLUSION: Current meta-analysis indicates that compared with interscalene nerve block, liposomal bupivacaine had comparative effectiveness on reducing both pain scores and the length of hospital stay. However, studies with more patients and better-designed methods are needed to establish the optimal regimen and the safety of liposomal bupivacaine in TSA patients. Wolters Kluwer Health 2017-07-07 /pmc/articles/PMC5502145/ /pubmed/28682872 http://dx.doi.org/10.1097/MD.0000000000007226 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 |
spellingShingle | 7100 Yan, Zeng Chen, Zong Ma, Chuangen Liposomal bupivacaine versus interscalene nerve block for pain control after shoulder arthroplasty: A meta-analysis |
title | Liposomal bupivacaine versus interscalene nerve block for pain control after shoulder arthroplasty: A meta-analysis |
title_full | Liposomal bupivacaine versus interscalene nerve block for pain control after shoulder arthroplasty: A meta-analysis |
title_fullStr | Liposomal bupivacaine versus interscalene nerve block for pain control after shoulder arthroplasty: A meta-analysis |
title_full_unstemmed | Liposomal bupivacaine versus interscalene nerve block for pain control after shoulder arthroplasty: A meta-analysis |
title_short | Liposomal bupivacaine versus interscalene nerve block for pain control after shoulder arthroplasty: A meta-analysis |
title_sort | liposomal bupivacaine versus interscalene nerve block for pain control after shoulder arthroplasty: a meta-analysis |
topic | 7100 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5502145/ https://www.ncbi.nlm.nih.gov/pubmed/28682872 http://dx.doi.org/10.1097/MD.0000000000007226 |
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