Table 7 Articles included in the review analyzing the use of ropivacaine in periarticular infiltrations

Danoff et al. [45]

RCT

29 bilateral TKA patients, 58 knees

Group 1: Liposomal bupivacaine and bupivacaine (EXP)

Group 2: Ropivacaine, epinephrine, ketorolac and clonidine

Periarticular infiltration

No significant difference in visual analog scale pain scores at any time point, no difference in functional recovery on POD 0–2

No complications

Amundsonet al. [67]

RCT

165 patients

Group 1: femoral catheter and sciatic nerve block

Group 2: Ropivacaine based periarticular injection

Group 3: Liposomal bupivacaine based periarticular injection

Group 1: Bupivacaine 0.5% bolus preop, 0.2% bolus in PACU. 0.25% single injection to sciatic nerve

Group 2: Ropivacaine 200–400 mg (weight based), 100 mcg epinephrine, 30 mg ketorolac

Group 3: 266 mg liposomal bupivacaine, 30 mg ketorolac, 125 mg bupivacaine, 125 mcg epinephrine

Ropivacaine and liposomal bupivacaine based periarticular injection provide comparable pain control on POD 1 and 2 to femoral catheter and single injection sciatic nerve block

No complications

Liu et al. [44]

RCT

134 patients undergoing UKA

Group 1: Ropivacaine, ketorolac, adrenaline, morphine, NS

Group 2: Bupivacaine, methylprednisolone, adrenaline, morphine, NS

Group one had significantly lower VAS scores at 6, 24, 48 and 72 h. ROM up to 14 days was superior

No complications

Leeuw et al. [79]

RCT

37

Group 1: 0.5% bupivacaine with 1:200,000 epinephrine, group 2: 0.5% ropivacaine

Posterior lumbar plexus block

Not clinically significant lower pain scores in ropivacaine group at 8, 12 and 24 h

No complications

Hungerford et al. [80]

RCT

100 patients; 54 in control and 46 in experimental

Group 1: Liposomal bupivacaine mixed with bupivacaine

Group 2: Ropivacaine (control drug)

Adductor canal block

No statistically significant difference in pain scores at 24, 48 and 72 h or length of stay

No complications

Xiao et al. [86]

RCT

120 THA patients

3 groups

(1) LIA in deep and superficial fascia

(2) LIA in all layers

(3) Control

80 mL 0.25% ropivacaine

Group 1: 40 mL after suturing deep fascia, 40 mL after suturing superficial fascia

Group 2: 40 mL to deep tissues, 40 mL to superficial tissues (including skin and subcutaneous)

Group 3: No infiltration

LIA with ropivacaine groups has lower resting VAS scores than control group at 2 and 6 h and lower VAS scores when mobilizing at 6 and 12 h. LIA groups have higher patient-reported satisfaction scores. Opioid consumption was similar in all 3 groups

No complications

van Haagen et al. [80]

RCT

128 TKA patients

Group A: 300-mg ropivacaine/600–300–300-mg gabapentin. Group B: 150-mg ropivacaine/600–300–300-mg gabapentin. Group C: 300-mg ropivacaine/300–100–100-mg gabapentin. Group D: 150-mg ropivacaine/300–100–100-mg gabapentin

Ropivacaine administered as LIA. Gabapentin administered po on first day after surgery

Significant difference in pain scores between group A and B, suggesting altering dose of ropivacaine influences the course of pain and gabapentin does not

None

Teratani [84]

RCT

128 arthroscopic rotator cuff repair patients

Cocktail group: 0.75% ropivacaine, 5 mg morphine, 0.3 mg epinephrine, 2 mg betamethasone, NS to a total of 42 mL. Control group: 0.75% ropivacaine and NS to a total of 42 mL

Injection into glenohumeral joint, subacromial bursa, suprascapular nerve, and deltoid muscle

VAS pain scores were lower in the cocktail group at 8, 16 and 24 h. No apparent detrimental effects on tendon healing

Lower suppository use in cocktail group, higher nausea rate in control group but not statistically significant