A direct meta-analysis illustrated that in people scheduled to undergo arthroplasty, the use of periarticular injection with a long-acting local anesthetic is associated with a reduction in postoperative pain and opioid consumption. Researchers aimed to examine the effectiveness and safety of periarticular injections in primary joint arthroplasty. For studies on periarticular injections in joint arthroplasty, databases were searched such as Cochrane Central Register of Controlled Trials, MEDLINE, and Embase.

All incorporated studies underwent qualitative and quantitative homogeneity testing. This was followed by a systematic review and direct comparison meta-analysis. To obtain the finest available data for analysis, a total of 60 out of 3,699 publications were selected and carefully analyzed. Addition of Ketorolac or a corticosteroid to long-acting local anesthetic (like Ropivacaine or Bupivacaine) were reported to offer additional advantages.

No difference exists between liposomal Bupivacaine and other non-liposomal long-acting local anesthetics. Morphine may worsen postoperative nausea and vomiting and exhibits no additive effect on postoperative pain or opioid usage. There is inadequate data on Epinephrine and Clonidine and their usage cannot be inferred from the data available.

The use of a periarticular injection with a long-acting local anesthetic to lessen postoperative pain and opiate intake is well-supported by the research. The intake of opioids may be decreased by combining a long-acting local anesthetic with a corticosteroid and/or Ketorolac to further minimize postoperative pain.