***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: & NA ; Adverse events in r and omized controlled trials of noninvasive , pharmacologic analgesics are frequently incompletely or inconsistently reported . A comprehensive reporting checklist is proposed to improve disclosure of adverse effects . & NA ; The development of valid and informative treatment risk – benefit profiles requires consistent and thorough information about adverse event ( AE ) assessment and participants ’ AEs during r and omized controlled trials ( RCTs ) . Despite a 2004 extension of the Consoli date d St and ards of Reporting Trials ( CONSORT ) statement recommending the specific AE information that investigators should report , there is little evidence that analgesic RCTs adequately adhere to these recommendations . This systematic review builds on prior recommendations by describing a comprehensive checklist for AE reporting developed to capture clinical ly important AE information . Using this checklist , we coded AE assessment methods and reporting in all 80 double‐blind RCTs of noninvasive pharmacologic treatments published in the European Journal of Pain , Journal of Pain , and PAIN ® from 2006 to 2011 . Across all trials , reports of AEs were frequently incomplete , inconsistent across trials , and , in some cases , missing . For example , > 40 % of trials failed to report any information on serious adverse events . Trials of participants with acute or chronic pain conditions and industry‐sponsored trials typically provided more and better‐ quality AE data than trials involving pain‐free volunteers or trials that were not industry sponsored . The results of this review suggest that improved AE reporting is needed in analgesic RCTs . We developed an ACTTION ( Analgesic , Anesthetic , and Addiction Clinical Trial Translations , Innovations , Opportunities , and Networks ) AE reporting checklist that is intended to assist investigators in thoroughly and consistently capturing and reporting these critically important data in publications BACKGROUND We studied the efficacy of local infiltration analgesia in surgical wounds with 0.2 % ropivacaine ( 50 mL ) , ketorolac ( 15 mg ) , and adrenaline ( 0.5 mg ) compared with that of local infiltration analgesia combined with continuous infusion of 0.2 % ropivacaine as a method of pain control after total hip arthroplasty . We hypothesized that as a component of multimodal analgesia , local infiltration analgesia followed by continuous infusion of ropivacaine would result in reduced postoperative opioid consumption and lower pain scores compared with infiltration alone , and that both of these techniques would be superior to placebo . METHODS In this prospect i ve , double-blind , placebo-controlled study , 105 patients were r and omized into three groups : Group I , in which patients received infiltration with ropivacaine , ketorolac , and adrenaline followed by continuous infusion of 0.2 % ropivacaine at 5 mL/hr ; Group II , in which patients received infiltration with ropivacaine , ketorolac , and adrenaline followed by continuous infusion of saline solution at 5 mL/hr ; and Group III , in which patients received infiltration with saline solution followed by continuous infusion of saline solution at 5 mL/hr . All patients received celecoxib , pregabalin , and acetaminophen perioperatively and patient-controlled analgesia ; surgery was performed under general anesthesia . Before wound closure , the tissues and periarticular space were infiltrated with ropivacaine , ketorolac , and adrenaline or saline solution and a fenestrated catheter was placed . The catheter was attached to a pump prefilled with either 0.2 % ropivacaine or saline solution set to infuse at 5 mL/hr . The primary outcome measure was postoperative opioid consumption and the secondary outcome measures were pain scores , adverse side effects , and patient satisfaction . RESULTS There were no differences between groups in the administration of opioids in the operating room , in the recovery room , or on the surgical floor . The pain scores on recovery room admission and discharge and the floor were low and similar between groups . There were no differences in the incidence of adverse side effects among groups . Patient satisfaction with pain management was similar in all groups . CONCLUSIONS Local infiltration analgesia alone or followed by continuous infusion of ropivacaine as part of multimodal analgesia provides no additional analgesic benefit or reduction in opioid consumption compared with placebo following total hip arthroplasty . LEVEL OF EVIDENCE Therapeutic level I. See Instructions for Authors for a complete description of levels of evidence Background : The analgesic effect of perioperative low doses of intravenous lidocaine has been demonstrated after abdominal surgery . This study aim ed to evaluate whether a continuous intravenous low-dose lidocaine infusion reduced  postoperative pain and modified nociceptive pain threshold after total hip arthroplasty . Methods : Sixty patients participated in this r and omized double-blinded study . Patients received lidocaine 1 % ( lidocaine group ) with a 1.5 mg/kg−1 intravenous bolus in 10 min followed by a 1.5 mg · kg−1 · h−1 intravenous infusion or saline ( control group ) . These regimens were started 30 min before surgical incision and stopped 1h after skin closure .  Lidocaine blood concentrations were measured at the end of administration . In both groups , postoperative analgesia was provided exclusively by patient-controlled intravenous morphine . Pain scores , morphine consumption , and operative hip flexion were recorded over 48 h. In addition , pressure pain thresholds and the extent of hyperalgesia around surgical incision were systematic ally measured at 24 and 48 h. Results : In comparison with the placebo , lidocaine did not induce any opioid-sparing effect during the first 24 h ( median [ 25–75 % interquartile range ] ; 17 mg [ 9–28 ] vs. 15 mg [ 8–23 ] ; P = 0.54 ) . There was no significant difference regarding the effects of lidocaine and placebo  on pain score , pressure pain thresholds , extent in the area of hyperalgesia , and maximal degree of active hip flexion tolerated . Mean plasma lidocaine concentration was 2.1 ± 0.4 & mgr;g/ml . Conclusion : Low dose perioperative intravenous lidocaine  after total hip arthroplasty offers no beneficial effect on postoperative analgesia and does not modify pressure and tactile pain thresholds Background Several reports have confirmed the ability of intraoperative periarticular injections to control pain after THA . However , these studies used differing combinations of analgesic agents and the contribution of each , including the local anesthetic agent , is uncertain . Underst and ing the independent effects of the various agents could assist in improved pain management after surgery . Questions / purpose sWe therefore determined the ability of intraoperative periarticular infiltration of levobupivacaine to ( 1 ) reduce postoperative pain , ( 2 ) reduce postoperative morphine requirements , and ( 3 ) reduce the incidence of nausea and urinary retention . Patients and Methods A double-blinded , r and omized , placebo-controlled trial of patients undergoing primary THAs was performed . Patients were r and omized to receive a periarticular infiltration of 150 mg levobupivacaine in 60 mL 0.9 % saline ( n = 45 ) or a placebo consisting of 60 mL 0.9 % saline ( n = 46 ) . We obtained a short-form McGill pain score , visual analog scale ( VAS ) , and morphine requirements via patient-controlled analgesia ( PCA ) as primary measures . Postoperative antiemetic requirements and need for catheterization for urinary retention were determined as secondary measures . Results Subjectively reported pain scores and the overall intensity scores were similar for both groups in the postoperative period . At the same time the mean morphine consumption was less in the levobupivacaine group , most notable in the first 12 hours after surgery : treatment group 11.5 mg vs control group 21.2 mg . We observed no differences in the frequency of postoperative nausea and vomiting or urinary retention . Conclusions Our observations suggest periarticular injection of levobupivacaine can supplement available postoperative analgesic techniques and reduce postoperative morphine requirements after THA.Level of Evidence Level I , therapeutic study . See Guidelines for Authors for a complete description of levels of evidence Background and Objectives : High-volume local infiltration analgesia ( LIA ) is widely applied as part of a multimodal pain management strategy in total hip arthroplasty ( THA ) . However , method ological problems hinder the exact interpretation of previous trials , and the evidence for LIA in THA remains to be clarified . Therefore , we evaluated whether intraoperative high-volume LIA , in addition to a multimodal oral analgesic regimen , would further reduce acute postoperative pain after THA . Methods : Patients scheduled for unilateral , primary THA under spinal anesthesia were included in this r and omized , double-blind , placebo-controlled trial receiving high-volume ( 150 mL ) wound infiltration with ropivacaine 0.2 % with epinephrine ( 10 & mgr;g/mL ) or saline 0.9 % . A multimodal oral analgesic regimen consisting of slow-release acetaminophen 2 g , celecoxib 400 mg , and gabapentin 600 mg was instituted preoperatively . Rescue analgesic consisted of oral oxycodone .  Pain was assessed repeatedly the first 8 hrs after surgery using the 100-mm visual analog scale . The primary end point was pain during walking ( 5 m ) 8 hrs after surgery . Secondary end points were pain at rest , pain on 45 degrees of passive flexion of the hip with the leg straight , and cumulative consumption of oxycodone .  Results : A total of 120 patients were included .  Pain during walking ( median [ interquartile range ] [ 95 % confidence interval ] ) was low in the ropivacaine versus the placebo group ( 20 [ 14 - 38 ] [ 0 - 93 ] vs 22 [ 10 - 40 ] [ 0 - 83 ] ) and did not differ significantly ( P = 0.71 ) . Consumption of rescue oxycodone  ( 5 mg [ 0 - 10 mg ] [ 0 - 24 mg ] vs 10 mg [ 0 - 15 mg ] [ 0 - 29 mg ] ) did not differ ( P = 0.45 ) . Conclusions : Intraoperative high-volume LIA with ropivacaine 0.2 % provided no additional reduction in acute pain after THA when combined with a multimodal oral analgesic regimen consisting of acetaminophen , celecoxib , and gabapentin and is therefore not recommended BACKGROUND : Ketamine has been shown to have a morphine-sparing effect soon after surgery . Nevertheless , whether this effect still exists after being combined with nonsteroidal antiinflammatory drugs and acetaminophen , and whether ketamine can decrease chronic pain after nononcologic surgery remain unclear . Thus , we design ed a study to assess ketamine ’s effect on acute and chronic postoperative pain when combined with multimodal analgesia after total hip arthroplasty ( THA ) . METHODS : Patients scheduled for primary nononcologic THA using st and ardized general anesthesia were r and omized . They received IV ketamine before incision ( 0.5 mg/kg ) , and a 24-h infusion ( 2 & mgr;g · kg−1 · min−1 ) or a similar blinded saline bolus and infusion . Postoperative analgesia included IV acetaminophen , ketoprofen , plus morphine/droperidol patient-controlled analgesia for 48 h. Data pertaining to pain scores , morphine consumption , and need for crutches were collected for 6 mo after THA . Our primary outcome was 24-h morphine consumption . RESULTS : One hundred fifty-four patients were included ( placebo , 75 ; ketamine , 79 ) . Patients and operative data were similar in both groups . Ketamine  decreased morphine consumption at 24 h from 19 ± 12 mg to 14 ± 13 mg ( P = 0.004 ) . At Day 30 , ketamine decreased the proportion of patients needing 2 crutches or a walking frame from 56 % to 31 % ( P = 0.0035 ) . From Day 30 to Day 180 , ketamine decreased the proportion of patients with persistent pain at rest in the operated hip ( P = 0.008 ) . At Day 180 , 21 % of placebo group patients ( 15 of 70 ) experienced pain at rest in the operated hip versus 8 % ( 6 of 72 ) in the ketamine group ( P = 0.036 , odds ratio 0.33 , 95 % confidence interval 0.12–0.91 , risk reduction 67 % ) . CONCLUSIONS : Ketamine had a morphine-sparing effect after THA , even when morphine was combined with multimodal systemic analgesia . It also facilitated rehabilitation at 1 mo and decreased postoperative chronic pain up to 6 mo after surgery Postoperative pain can have a significant effect on patient recovery . An underst and ing of patient attitudes and concerns about postoperative pain is important for identifying ways health care professionals can improve postoperative care . To assess patients ’ postoperative pain experience and the status of acute pain management , we conducted a national study by using telephone question na 
    Output:
    
Non-steroidal anti-inflammatory drugs and lumbar plexus block were demonstrated to provide reductions in postoperative pain scores .
Intrathecal opioids increased pruritus , and lumbar plexus block reduced nausea and pruritus .
This review demonstrated , that some analgesic interventions may have the capacity to reduce mean opioid requirements and /or mean pain intensity compared with controls , but the available r and omized placebo-controlled trials does not allow a design ation of a " best proven intervention " for THA