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Comparison of Adductor Canal Block and Femoral Nerve Block for Postoperative Pain in Total Knee Arthroplasty

View Article: PubMed Central - PubMed

ABSTRACT

A total knee arthroplasty (TKA) has always been associated with moderate-to-severe pain. A systematic review of randomized controlled trials (RCTs) and non-RCTs was performed to evaluate the efficacy and safety of pain control of adductor canal block (ACB) and femoral nerve block (FNB) after TKA.

Relevant literatures about the ACB and FNB after TKA for reducing pain were searched from Medline (1996-January, 2015), Embase (1980-January, 2015), PubMed (1980-January, 2015), Web of Science (1980-January, 2015), and The Cochrane Central Register of Controlled Trials. High-quality RCTs and non-RCTs were picked to evaluate the visual analogue scale (VAS) and other outcome. This systematic review and meta-analysis were performed according to the PRISMA statement criteria. The software RevMan 5.30 was used for the meta-analysis.

Eight literatures fitted into the inclusion criteria. There were no significant differences in VAS score with rest or mobilization at 4, 24, and 48 h between ACB group and FNB group. There were also no significant differences in the strength of quadriceps and adductor, the length of hospital stay, and complications of vomiting and nausea.

Present meta-analysis indicated that ACB shows no superiority than FNB group. Both of them can reduce the pain score after TKA. As referred to which method to adopt, it is determined by the preference of the surgeons and anesthesiologists.

No MeSH data available.


Funnel plot of studies analysing the effect of visual analogue scale score on the final results.
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Figure 5: Funnel plot of studies analysing the effect of visual analogue scale score on the final results.

Mentions: A total of 7 component studies (808 patients) provided VAS score at 24 h postoperatively. There was no statistically significant difference between the groups with respect to the VAS score at 24 h postoperatively (Figure 4) (MD = 1.34; 95% CI −2.35 to 5.04; P = 0.48). Studies included in Figure 4 were also assessed for any potential publication bias through a funnel plot (Figure 5). From the funnel plot, the horizontal axis meaning mean difference on and vertical axis stands for the standard error of the mean difference.


Comparison of Adductor Canal Block and Femoral Nerve Block for Postoperative Pain in Total Knee Arthroplasty
Funnel plot of studies analysing the effect of visual analogue scale score on the final results.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998367&req=5

Figure 5: Funnel plot of studies analysing the effect of visual analogue scale score on the final results.
Mentions: A total of 7 component studies (808 patients) provided VAS score at 24 h postoperatively. There was no statistically significant difference between the groups with respect to the VAS score at 24 h postoperatively (Figure 4) (MD = 1.34; 95% CI −2.35 to 5.04; P = 0.48). Studies included in Figure 4 were also assessed for any potential publication bias through a funnel plot (Figure 5). From the funnel plot, the horizontal axis meaning mean difference on and vertical axis stands for the standard error of the mean difference.

View Article: PubMed Central - PubMed

ABSTRACT

A total knee arthroplasty (TKA) has always been associated with moderate-to-severe pain. A systematic review of randomized controlled trials (RCTs) and non-RCTs was performed to evaluate the efficacy and safety of pain control of adductor canal block (ACB) and femoral nerve block (FNB) after TKA.

Relevant literatures about the ACB and FNB after TKA for reducing pain were searched from Medline (1996-January, 2015), Embase (1980-January, 2015), PubMed (1980-January, 2015), Web of Science (1980-January, 2015), and The Cochrane Central Register of Controlled Trials. High-quality RCTs and non-RCTs were picked to evaluate the visual analogue scale (VAS) and other outcome. This systematic review and meta-analysis were performed according to the PRISMA statement criteria. The software RevMan 5.30 was used for the meta-analysis.

Eight literatures fitted into the inclusion criteria. There were no significant differences in VAS score with rest or mobilization at 4, 24, and 48 h between ACB group and FNB group. There were also no significant differences in the strength of quadriceps and adductor, the length of hospital stay, and complications of vomiting and nausea.

Present meta-analysis indicated that ACB shows no superiority than FNB group. Both of them can reduce the pain score after TKA. As referred to which method to adopt, it is determined by the preference of the surgeons and anesthesiologists.

No MeSH data available.