| Femoral nerve block improves analgesia outcomes after total knee arthroplasty: a meta-analysis of randomized controlled trials. | |
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MedLine Citation:
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PMID: 20966667 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Femoral nerve blockade (FNB) is a common method of analgesia for postoperative pain control after total knee arthroplasty. We conducted a systematic review to compare the analgesia outcomes in randomized controlled trials that compared FNB (with and without sciatic nerve block) with epidural and patient-controlled analgesia (PCA). METHODS: We identified 23 randomized controlled trials that compared FNB with PCA or epidural analgesia. These studies included 1,016 patients, 665 with FNB, 161 with epidural, and 190 with PCA alone. RESULTS: All 10 studies of single-shot FNB (SSFNB) used concurrent PCA opioids. SSFNB was found to reduce PCA morphine consumption at 24 h (-19.9 mg, 95% credible interval [CrI]: -35.2 to -4.6) and 48 h (-38.0 mg, 95% CrI: -56.0 to -19.7), pain scores with activity (but not at rest) at 24 and 48 h (-1.8 visual analog pain scale, 95% CrI: -3.3 to -0.02 at 24 h; -1.5 visual analog pain scale, 95% CrI: -2.9 to -0.02 at 48 h) and reduce the incidence of nausea (0.37 odds ratio, 95% CrI: 0.1 to 0.9) compared with PCA alone. SSFNB had similar morphine consumption and pain scores compared with SSFNB plus sciatic nerve block, and SSFNB plus continuous FNB. CONCLUSIONS: SSFNB or continuous FNB (plus PCA) was found to be superior to PCA alone for postoperative analgesia for patients having total knee arthroplasty. The impact of adding a sciatic block or continuous FNB to a SSFNB needs to be studied further. |
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Authors:
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James E Paul; Aman Arya; Lindsay Hurlburt; Ji Cheng; Lehana Thabane; Antonella Tidy; Yamini Murthy |
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Publication Detail:
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Type: Comparative Study; Journal Article; Meta-Analysis; Review |
Journal Detail:
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Title: Anesthesiology Volume: 113 ISSN: 1528-1175 ISO Abbreviation: Anesthesiology Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-22 Completed Date: 2010-11-09 Revised Date: 2011-07-13 |
Medline Journal Info:
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Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: United States |
Other Details:
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Languages: eng Pagination: 1144-62 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada. james_paul@sympatico.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Analgesia
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methods Analgesia, Patient-Controlled* / methods Arthroplasty, Replacement, Knee* / methods Femoral Nerve* / physiology Humans Nerve Block* / methods Pain Measurement / methods Pain, Postoperative / prevention & control Randomized Controlled Trials as Topic* / methods Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Anesthesiology. 2011 Jun;114(6):1494-5; author reply 1495
[PMID:
21610464
]
Anesthesiology. 2010 Nov;113(5):1014-5 [PMID: 20881593 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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