Table 13c: Postoperative intra-articular LA bolus versus placebo

Table 13c: Postoperative intra-articular LA bolus versus placebo: study details and qualitative outcomes


n treatment/



Supplemental analgesic

VAS scores and type of pain, where specified

Time to first analgesic request

Use of supplemental analgesic

Other important outcomes

Badner 1997

(LoE 1)


30 ml saline before incision and 0.5% bupivacaine (30 ml) + 1:200,000 epinephrine in saline after wound closure (Bup) vs. 30 ml saline for both injections (Pb)

Postop: PCA-morphine for 24 h

NS at all time points (i.e. at 1, 2, 4 and 24 h after arrival in PACU)


Morphine consumption in 1st 24 h: Bup superior (p=0.006)


VRS scores: NS



Functional outcomes

Range of motion at discharge: Bup superior (p=0.009)


Side-effects (urinary retention, pruritus, somnolence): NS

Mauerhan 1997

(LoE 1)


After wound closure but before tourniquet release, 30 ml intra-articular injection containing: 50 mg bupivacaine (Bup) vs. saline (Pb)

Postop: PCA-morphine sulphate for 24 h

Bup superior at 4 h (p<0.05), but NS at 2, 6, 24 or 48 h


NS during 1st 24 h postop


Ritter 1999

(LoE 1)


Intra-articular injection after skin closure: 10 ml bupivacaine (2.5 mg/ml) (Bup) vs. 10 ml saline (Pb)

Postop analgesia: ketorolac, pethidine morphine (usually by PCA), for 24 h

NS over 24 h postop (McGill-Melzack 0–5 scale)


Ketorolac, pethidine and morphine consumption at 24 h: NS

Hospital stay

Length of hospital stay: NS