Liposomal bupivacaine administration is not superior to traditional periarticular injection for postoperative pain management following total knee arthroplasty: a meta-analysis of randomized controlled trials

Table 2 Quality of each outcome of TKA using GRADE system

Outcomes	No. of included studies	No. of patients		(S)MD or RR (95%CI)	Heterogeneity	Quality of evidence (GRADE)
Outcomes	No. of included studies	LB	TPAI	(S)MD or RR (95%CI)	Heterogeneity	Quality of evidence (GRADE)
VAS at POD0 (Bupivacaine)	[23, 31]	129	131	− 0.28 [− 1.16, 0.60]	I2 = 60%, P = 0.11	Moderate²
VAS at POD0 (Cocktail)	[27, 28, 32]	78	76	− 0.02 [− 0.51, 0.47]	I2 = 51%, P = 0.13	Low^1,2
VAS at POD1 (Bupivacaine)	[23, 24, 26, 29, 31, 34]	346	345	− 0.15 [− 0.73, 0.43]	I2 = 60%, P = 0.03	Low^1,5
VAS at POD1 (Cocktail)	[25, 27, 28, 30, 32, 33]	231	228	− 0.04 [− 0.32, 0.24]	I2 = 20%, P = 0.28	Moderate¹
VAS at POD2 (Bupivacaine)	[23, 24, 29, 31, 34]	283	302	− 0.20 [− 0.62, 0.22]	I2 = 6%, P = 0.37	Moderate¹
VAS at POD2 (Cocktail)	[25, 27, 28, 30, 32, 33]	231	228	− 0.05 [− 0.26, 0.17]	I2 = 59%, P = 0.03	Low^1,5
VAS at POD3 (Bupivacaine)	[24, 29, 31]	213	202	0.00 [− 0.42, 0.42]	I2 = 0%, P = 0.79	High
VAS at POD3 (Cocktail)	[25, 28]	89	86	0.07 [0.00, 0.14]	I2 = 0%, P = 0.84	Moderate¹
Opioid consumption at 24 h	[26,27,28,29, 33]	229	222	− 0.02 [− 0.21, 0.16]	I2 = 56%, P = 0.06	Moderate¹
Opioid consumption at 48 h	[27,28,29, 33]	166	160	− 0.22 [− 0.44, − 0.01]	I2 = 46%, P = 0.14	Moderate¹
Opioid consumption at 72 h	[27,28,29]	114	108	− 0.32 [− 0.83, 0.19]	I2 = 69%, P = 0.04	Moderate¹
Nausea and vomiting	[15, 19, 23, 24, 28, 36]	284	282	0.79 [0.53, 1.16]	I2 = 54%, P = 0.05	High
Length of hospital stay	[19, 24,25,26, 30, 31, 33, 36]	474	454	0.07 [− 0.03, 0.17]	I2 = 29%, P = 0.20	Moderate¹

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate
Very low quality: We are very uncertain about the estimate
¹Risk of bias
²Inconsistency
³Indirectness
⁴Imprecision
⁵Publication bias

ISSN: 1749-799X