Author, year Type of surgery Study design Intervention Control Pain scores Opioid consumption Function Length of stay comment Andersen et al. [12 ] 2007 THA RCT
LIA 100 mL: ropivacaine 200 mg + epi 0.5 mg + ketorolac 30 mg IA bolus 20 mL (ropivacaine 150 mg + epinephrine 0.5 mg + ketorolac 30 mg at 8 hrs) Epidural to 20 hours Lower VAS LIA group from 20 to 96 hours
to
(variable with time) Reduced in LIA group
for first 20 hrs,
for total study period up to 96 hrs More patients able to walk at 8 hours in LIA group
Reduced LIA group 4.5 (3–6) versus 7 (5.5–7) days (mean, range),
1 Jadad score = 3 96 hour followup Andersen et al. [10 ] 2007 THA RCT
LIA 150 mL: ropivacaine 300 mg + ketorolac 30 mg + epinephrine 0.5 mg IA bolus next morning 20 mL of mixture Saline infiltration and injection Lower in LIA group from 4 hours up to 2 weeks
to
(variable with time) Lower in LIA group
to
(variable with time) Better at 1 week with LIA (
), no difference after No difference Jadad score = 4 6-week followup Andersen et al. [14 ] 2011 Bilateral THA RCT
LIA: ropivacaine 340 mg + epinephrine 1.7 mg to one hip Saline to control hip Low, similar between hips N/R 4 days median Jadad score = 4 48-hour followup Bianconi et al. [9 ] 2003 TKA and THA Results pertain to THA (
) RCT
LIA 40 mL: ropivacaine 200 mg Extra-articular infusion ropivacaine 10 mg/hr for 55 hrs Extra-articular saline infusion Lower scores in LIA group at rest and on movement up to 72 hours
Lower in LIA group
Reduction in length of hospital stay in LIA group 6.34 (0.67) versus 8.79 (1.39) days (mean, SD)
Jadad score = 4 72-hour followup Busch et al. [11 ] 2010 THA RCT
LIA 100 mL: ropivacaine 400 mg + epinephrine 0.6 mg + ketorolac 30 mg + morphine 5 mg Nil Lower VAS on movement in PACU in LIA group
Lower PCA use first 24 hours in LIA group
Jadad score = 5 6-week followup Kerr and Kohan [6 ] 2008 TKA THA HRA Results pertain to all surgery types not only THA (
) Series
LIA 150 mL: ropivacaine 300 mg + epinephrine 1.5 mg + ketorolac 30 mg IA bolus 50 mL of mixture at 15–20 hours No control Pain control satisfactory with NRS of 0–3/10 2/3 of patients did not require opioid analgesia Lunn et al. [15 ] 2011 THA RCT
LIA: ropivacaine 300 mg + epinephrine 1.5 mg Multimodal analgesic regime Saline infiltration multimodal analgesic regime No difference between groups
No difference between groups
N/R N/R Jadad score = 5 8-hour followup Otte et al. [7 ] 2008 TKA HR Results pertain to HRA group Series
LIA150 mL: ropivacaine 300 mg + epinephrine 1.5 mg No control VAS scores at rest:
Replication of Kerr and Kohan technique Parvata-neni et al. [8 ] 2007 THA and TKA Results pertain to THA group (
) RCT
LIA: bupivacaine 200–400 mg + morphine 4–10 mg + epinephrine 0.3 mg + methylprednisolone 40 mg + cefuroxime 750 mg + saline 22 mL TKA: FNB + PCA THA: PCA No infiltration Lower pain scores in THA patients in LIA group
More patients able to SLR on POD 1 in LIA group 52% versus 15%,
THA patients in LIA group had reduced length of stay 3.2 versus 4.2 days (mean),
Jadad score = 3 3-month followup Specht et al. [13 ] 2011 THA RCT
LIA: ropivacaine 200 mg + ketorolac 30 mL + epinephrine 1 mg (102 mL) 51 mL of the solution via IA catheter at 10 and 22 hrs multimodal analgesic regime Also LIA. Saline via catheter at 10 and 22 hrs multimodal analgesic regime No difference between groups
to
Further statistical analysis meant that this result “should be regarded as insignificant” as per authors Similar between groups
N/R Trend to shorter in intervention group, NS 3 (2–6) versus 3 (2–7) days (mean, range)
Jadad score = 5 Followup 3 days