Intra-articular bupivacaine after joint arthroplasty: a systematic review and meta-analysis of randomised placebo-controlled studies

11 randomized controlled trials were included in this meta-analysis and systematic review to determine the efficacy and safety of intraarticular (IA) bupivacaine, when compared to a placebo, for pain relief after a total joint arthroplasty (TJA) procedure. The primary outcome was postoperative pain relief (n=8 RCTs) and the secondary outcome was narcotic consumption (n=9 RCTs). Findings indicated significantly reduced pain scores after 24 hours postoperatively following treatment with IA bupivacaine compared to placebo. Additionally, significantly reduced narcotic consumption after 24 hours and between 24 and 48 hours postoperatively was observed in the IA bupivacaine group compared to placebo. Pain from 24 to 48 hours postoperatively, as well as the incidence of adverse events, did not significantly differ between IA bupivacaine and placebo groups.