Comparison of local infiltration and epidural analgesia for postoperative pain control in total knee arthroplasty and total hip arthroplasty: A systematic review and meta-analysis

Nine randomized controlled trials were included in this meta-analysis investigating the comparative analgesic efficacy and safety of local infiltration analgesia and epidural analgesia in total knee and total hip arthroplasty. When assessed in total knee arthroplasty, LIA demonstrated significantly lower pain at rest from 48-72hr postoperatively, significantly lower pain on movement at 48hr postoperatively, and significantly greater range of knee flexion from 24-72hr postoperatively in comparison to epidural analgesia. When assessed in total hip arthroplasty, LIA demonstrated significantly greater pain on movement at 24hr postoperatively, and no significant differences in pain at rest or on movement thereafter. Groups did not significantly differ in the incidence of nausea or infection.