Study Summary

Eleven randomized controlled trials were included in this meta-analysis comparing intrathecal injection to local infiltration analgesia (LIA) for pain management following total joint arthroplasty (TJA). The outcomes of interest included pain at rest and during mobilization on a Visual Analog Scale (VAS), morphine consumption, length of hospital stay, and the risk of adverse events. Pooled VAS pain scores at rest were statistically significantly in favour of of the local infiltration analgesia group, at 6, 12, 24, 48, and 72-hours post-operation (p<0.05 for all). Similarly, pooled VAS pain scores during mobilization were statistically significantly in favour of the local infiltration analgesia group, at 6, 12, 48, and 72 hours post-operation. Pooled morphine consumption (p<0.001), length of hospital stay (p<0.001), risk of nausea (p<0.001) and risk of pruritus (p<0.001) were all statistically significantly in favour of the local infiltration analgesia group. The pooled risk of respiratory depression was not statistically significantly different between the two groups.