Abstract
BackgroundThis meta-analysis aimed to perform a meta-analysis to evaluate the efficiency and safety between local infiltration analgesia (LIA) and sciatic nerve block (SNB) when combined with femoral nerve block (FNB) after total knee arthroplasty (TKA).MethodsA systematic search was performed in MEDLINE (1966-2017.04), PubMed (1966-2017.04), Embase (1980-2017.04), ScienceDirect (1985-2017.04), and the Cochrane Library. Only high-quality studies were selected. Meta-analysis was performed using Stata 11.0 software.ResultsFour randomized controlled trials (RCTs) and two non-randomized controlled trials (non-RCTs), including 273 patients met the inclusion criteria. The present meta-analysis indicated that there were significant differences between groups in terms of visual analogue scale (VAS) score at 12 h (SMD = −0.303, 95% CI −0.543 to −0.064, P = 0.013), VAS score at 24 h (SMD = −0.395, 95% CI −0.636 to −0.154, P = 0.001), morphine equivalent consumption at 24 h (SMD = −0.395, 95% CI −0.636 to −0.154, P = 0.001), and incidence of nausea (RD = 0.233, 95% CI 0.107 to 0.360, P = 0.000) and vomiting (RD = 0.131, 95% CI 0.025 to 0.237, P = 0.015).ConclusionFNB-combined SNB provides superior pain relief and less morphine consumption within the first 24 h compared FNB-combined LIA in total knee arthroplasty. In addition, there were fewer side effects associated with SNB. Because the sample size and the number of included studies were limited, a multicenter RCT is needed to identify the effects of the two kinds of methods and further work must include range of motion analyses and functional test.
Highlights
This meta-analysis aimed to perform a meta-analysis to evaluate the efficiency and safety between local infiltration analgesia (LIA) and sciatic nerve block (SNB) when combined with femoral nerve block (FNB) after total knee arthroplasty (TKA)
A meta-analysis of randomized controlled trials (RCTs) was conducted to compare the efficacy and safety of pain control with SNB versus LIA when combined with FNB after TKA
Inclusion and exclusion criteria Studies were considered eligible if they met the following criteria: (1) Published clinical randomized control trails (RCTs) and non-RCTs; (2) Patients undergoing TKA, experiment group received SNB-combined FNB for pain control and control group received LIA-combined FNB; (3) Reported surgical outcomes, including visual analogue scale (VAS) scores, morphine consumption, length of stay, and postoperative adverse effects including the risk of nausea and vomiting
Summary
This meta-analysis aimed to perform a meta-analysis to evaluate the efficiency and safety between local infiltration analgesia (LIA) and sciatic nerve block (SNB) when combined with femoral nerve block (FNB) after total knee arthroplasty (TKA). Total knee arthroplasty (TKA) is a common procedure for improving mobility and quality of life in patients with osteoarthritis or rheumatoid arthritis. Adequate and effective pain relief is requested, mainly to improve patient satisfaction, to expedite mobilization and rehabilitation, to decrease the duration of hospital stay, and . Fundamental research has shown that knee joint is innervated by sciatic nerves; FNB combined sciatic nerves block (SNB) has become growing practice to provide improved pain relief. A meta-analysis of randomized controlled trials (RCTs) was conducted to compare the efficacy and safety of pain control with SNB versus LIA when combined with FNB after TKA
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