Analgesic Impact of Single-Shot Versus Continuous Femoral Nerve Block After Total Knee Arthroplasty: A Systematic Review and Meta-Analysis
Introduction Efficient pain management after total knee arthroplasty will accelerate functional recovery and reduce the length of hospital stay. The femoral nerve block is increasingly used in clinical practice owing to its favorable analgesic efficacy. However, the effect of continuous femoral nerv...
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| Veröffentlicht in: | Advances in therapy 2020-02, Vol.37 (2), p.671-685 |
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| creator | Li, Shiyi Zhou, Jinpeng Li, Xiuyan Teng, Xiufei Li, Yang Du, Chenyang Zhu, Junchao |
| description | Introduction
Efficient pain management after total knee arthroplasty will accelerate functional recovery and reduce the length of hospital stay. The femoral nerve block is increasingly used in clinical practice owing to its favorable analgesic efficacy. However, the effect of continuous femoral nerve block compared to single-shot femoral nerve block remains controversial.
Methods
Three databases (Pubmed, Embase and Cochrane Library) were searched for randomized controlled trials up to April 2019. Seven studies with 525 patients were included in this analysis.
Results
The pooled estimates showed that the continuous femoral nerve block could relieve the pain at rest [standardized mean differences with 95% confidence intervals 1.12 (0.63–1.60),
I
2
= 57%,
p
|
| doi_str_mv | 10.1007/s12325-019-01194-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2336257124</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2336257124</sourcerecordid><originalsourceid>FETCH-LOGICAL-c347t-2eaddcd0f7f35fe7368dc21931ea88792d942f5a5b0c87388cdd360509cb155b3</originalsourceid><addsrcrecordid>eNp9UU1v1DAQtRAV3Rb-AAfkIxeDP-LY4RZWFCraIrEFcbO89mSbksSL7bTa_gR-NS5beuQwmtHMmzcfD6GXjL5hlKq3iXHBJaGsKcaaitw9QQuma0mK8adoQVXFCBf6xyE6SumaUk6V1M_QoWANl3WlF-h3O9lhA6l3-HTcWpdx6PCqnzYDkNVVyPg7xDQnvAxT7qc5lPAExhDtgC8g3gB-PwT3E7ddhogvQy75zxMAbmO-imE72JR373CLV7uUYbS5zPkKNz3cYjt5fA7ZkvsNdqlPz9FBZ4cELx78Mfp28uFy-Ymcffl4umzPiBOVyoSD9d552qlOyA6UqLV3nDWCgdVaNdw3Fe-klWvqtBJaO-9FTSVt3JpJuRbH6PWedxvDrxlSNmOfHAyDnaDcZ7gQNZeK8apA-R7qYkgpQme2sR9t3BlGzb0GZq-BKRqYvxqYu9L06oF_Xo_gH1v-Pb0AxB6QSmnaQDTXYY7lC-l_tH8AXkyUKw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2336257124</pqid></control><display><type>article</type><title>Analgesic Impact of Single-Shot Versus Continuous Femoral Nerve Block After Total Knee Arthroplasty: A Systematic Review and Meta-Analysis</title><source>SpringerLink Journals - AutoHoldings</source><creator>Li, Shiyi ; Zhou, Jinpeng ; Li, Xiuyan ; Teng, Xiufei ; Li, Yang ; Du, Chenyang ; Zhu, Junchao</creator><creatorcontrib>Li, Shiyi ; Zhou, Jinpeng ; Li, Xiuyan ; Teng, Xiufei ; Li, Yang ; Du, Chenyang ; Zhu, Junchao</creatorcontrib><description>Introduction
Efficient pain management after total knee arthroplasty will accelerate functional recovery and reduce the length of hospital stay. The femoral nerve block is increasingly used in clinical practice owing to its favorable analgesic efficacy. However, the effect of continuous femoral nerve block compared to single-shot femoral nerve block remains controversial.
Methods
Three databases (Pubmed, Embase and Cochrane Library) were searched for randomized controlled trials up to April 2019. Seven studies with 525 patients were included in this analysis.
Results
The pooled estimates showed that the continuous femoral nerve block could relieve the pain at rest [standardized mean differences with 95% confidence intervals 1.12 (0.63–1.60),
I
2
= 57%,
p
< 0.00001] and physical therapy [standardized mean differences with 95% confidence intervals 1.05 (0.47–1.63),
I
2
= 71%,
p
= 0.0004] on postoperative day 1 and reduce total morphine consumption on postoperative day 1 [mean differences with 95% confidence intervals 16.15 (13.75–18.54),
I
2
= 46%,
p
< 0.00001] and 2 [mean differences with 95% confidence intervals 7.02 (4.82–9.22),
I
2
= 35%,
p
< 0.00001]. There is no significant difference in pain scores at rest and physical therapy on postoperative day 2 and 3, in Western Ontario and McMaster University Arthritis Index scores (
p
= 0.12), the length of hospital stay (
p
= 0.94) and the incidence of nausea and vomiting (
p
= 0.09).
Conclusion
We conclude that the continuous femoral nerve block is more effective than single-shot femoral nerve block after total knee arthroplasty, which provides objective evidence of pain management for anesthetists.</description><identifier>ISSN: 0741-238X</identifier><identifier>EISSN: 1865-8652</identifier><identifier>DOI: 10.1007/s12325-019-01194-z</identifier><identifier>PMID: 31925648</identifier><language>eng</language><publisher>Cheshire: Springer Healthcare</publisher><subject>Cardiology ; Endocrinology ; Health technology assessment ; Internal Medicine ; Medicine ; Medicine & Public Health ; Oncology ; Pharmacology/Toxicology ; Review ; Rheumatology</subject><ispartof>Advances in therapy, 2020-02, Vol.37 (2), p.671-685</ispartof><rights>Springer Healthcare Ltd., part of Springer Nature 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-2eaddcd0f7f35fe7368dc21931ea88792d942f5a5b0c87388cdd360509cb155b3</citedby><cites>FETCH-LOGICAL-c347t-2eaddcd0f7f35fe7368dc21931ea88792d942f5a5b0c87388cdd360509cb155b3</cites><orcidid>0000-0001-7650-1811</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12325-019-01194-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12325-019-01194-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31925648$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Shiyi</creatorcontrib><creatorcontrib>Zhou, Jinpeng</creatorcontrib><creatorcontrib>Li, Xiuyan</creatorcontrib><creatorcontrib>Teng, Xiufei</creatorcontrib><creatorcontrib>Li, Yang</creatorcontrib><creatorcontrib>Du, Chenyang</creatorcontrib><creatorcontrib>Zhu, Junchao</creatorcontrib><title>Analgesic Impact of Single-Shot Versus Continuous Femoral Nerve Block After Total Knee Arthroplasty: A Systematic Review and Meta-Analysis</title><title>Advances in therapy</title><addtitle>Adv Ther</addtitle><addtitle>Adv Ther</addtitle><description>Introduction
Efficient pain management after total knee arthroplasty will accelerate functional recovery and reduce the length of hospital stay. The femoral nerve block is increasingly used in clinical practice owing to its favorable analgesic efficacy. However, the effect of continuous femoral nerve block compared to single-shot femoral nerve block remains controversial.
Methods
Three databases (Pubmed, Embase and Cochrane Library) were searched for randomized controlled trials up to April 2019. Seven studies with 525 patients were included in this analysis.
Results
The pooled estimates showed that the continuous femoral nerve block could relieve the pain at rest [standardized mean differences with 95% confidence intervals 1.12 (0.63–1.60),
I
2
= 57%,
p
< 0.00001] and physical therapy [standardized mean differences with 95% confidence intervals 1.05 (0.47–1.63),
I
2
= 71%,
p
= 0.0004] on postoperative day 1 and reduce total morphine consumption on postoperative day 1 [mean differences with 95% confidence intervals 16.15 (13.75–18.54),
I
2
= 46%,
p
< 0.00001] and 2 [mean differences with 95% confidence intervals 7.02 (4.82–9.22),
I
2
= 35%,
p
< 0.00001]. There is no significant difference in pain scores at rest and physical therapy on postoperative day 2 and 3, in Western Ontario and McMaster University Arthritis Index scores (
p
= 0.12), the length of hospital stay (
p
= 0.94) and the incidence of nausea and vomiting (
p
= 0.09).
Conclusion
We conclude that the continuous femoral nerve block is more effective than single-shot femoral nerve block after total knee arthroplasty, which provides objective evidence of pain management for anesthetists.</description><subject>Cardiology</subject><subject>Endocrinology</subject><subject>Health technology assessment</subject><subject>Internal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Pharmacology/Toxicology</subject><subject>Review</subject><subject>Rheumatology</subject><issn>0741-238X</issn><issn>1865-8652</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9UU1v1DAQtRAV3Rb-AAfkIxeDP-LY4RZWFCraIrEFcbO89mSbksSL7bTa_gR-NS5beuQwmtHMmzcfD6GXjL5hlKq3iXHBJaGsKcaaitw9QQuma0mK8adoQVXFCBf6xyE6SumaUk6V1M_QoWANl3WlF-h3O9lhA6l3-HTcWpdx6PCqnzYDkNVVyPg7xDQnvAxT7qc5lPAExhDtgC8g3gB-PwT3E7ddhogvQy75zxMAbmO-imE72JR373CLV7uUYbS5zPkKNz3cYjt5fA7ZkvsNdqlPz9FBZ4cELx78Mfp28uFy-Ymcffl4umzPiBOVyoSD9d552qlOyA6UqLV3nDWCgdVaNdw3Fe-klWvqtBJaO-9FTSVt3JpJuRbH6PWedxvDrxlSNmOfHAyDnaDcZ7gQNZeK8apA-R7qYkgpQme2sR9t3BlGzb0GZq-BKRqYvxqYu9L06oF_Xo_gH1v-Pb0AxB6QSmnaQDTXYY7lC-l_tH8AXkyUKw</recordid><startdate>20200201</startdate><enddate>20200201</enddate><creator>Li, Shiyi</creator><creator>Zhou, Jinpeng</creator><creator>Li, Xiuyan</creator><creator>Teng, Xiufei</creator><creator>Li, Yang</creator><creator>Du, Chenyang</creator><creator>Zhu, Junchao</creator><general>Springer Healthcare</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7650-1811</orcidid></search><sort><creationdate>20200201</creationdate><title>Analgesic Impact of Single-Shot Versus Continuous Femoral Nerve Block After Total Knee Arthroplasty: A Systematic Review and Meta-Analysis</title><author>Li, Shiyi ; Zhou, Jinpeng ; Li, Xiuyan ; Teng, Xiufei ; Li, Yang ; Du, Chenyang ; Zhu, Junchao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-2eaddcd0f7f35fe7368dc21931ea88792d942f5a5b0c87388cdd360509cb155b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Cardiology</topic><topic>Endocrinology</topic><topic>Health technology assessment</topic><topic>Internal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Oncology</topic><topic>Pharmacology/Toxicology</topic><topic>Review</topic><topic>Rheumatology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Shiyi</creatorcontrib><creatorcontrib>Zhou, Jinpeng</creatorcontrib><creatorcontrib>Li, Xiuyan</creatorcontrib><creatorcontrib>Teng, Xiufei</creatorcontrib><creatorcontrib>Li, Yang</creatorcontrib><creatorcontrib>Du, Chenyang</creatorcontrib><creatorcontrib>Zhu, Junchao</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Advances in therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Shiyi</au><au>Zhou, Jinpeng</au><au>Li, Xiuyan</au><au>Teng, Xiufei</au><au>Li, Yang</au><au>Du, Chenyang</au><au>Zhu, Junchao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Analgesic Impact of Single-Shot Versus Continuous Femoral Nerve Block After Total Knee Arthroplasty: A Systematic Review and Meta-Analysis</atitle><jtitle>Advances in therapy</jtitle><stitle>Adv Ther</stitle><addtitle>Adv Ther</addtitle><date>2020-02-01</date><risdate>2020</risdate><volume>37</volume><issue>2</issue><spage>671</spage><epage>685</epage><pages>671-685</pages><issn>0741-238X</issn><eissn>1865-8652</eissn><abstract>Introduction
Efficient pain management after total knee arthroplasty will accelerate functional recovery and reduce the length of hospital stay. The femoral nerve block is increasingly used in clinical practice owing to its favorable analgesic efficacy. However, the effect of continuous femoral nerve block compared to single-shot femoral nerve block remains controversial.
Methods
Three databases (Pubmed, Embase and Cochrane Library) were searched for randomized controlled trials up to April 2019. Seven studies with 525 patients were included in this analysis.
Results
The pooled estimates showed that the continuous femoral nerve block could relieve the pain at rest [standardized mean differences with 95% confidence intervals 1.12 (0.63–1.60),
I
2
= 57%,
p
< 0.00001] and physical therapy [standardized mean differences with 95% confidence intervals 1.05 (0.47–1.63),
I
2
= 71%,
p
= 0.0004] on postoperative day 1 and reduce total morphine consumption on postoperative day 1 [mean differences with 95% confidence intervals 16.15 (13.75–18.54),
I
2
= 46%,
p
< 0.00001] and 2 [mean differences with 95% confidence intervals 7.02 (4.82–9.22),
I
2
= 35%,
p
< 0.00001]. There is no significant difference in pain scores at rest and physical therapy on postoperative day 2 and 3, in Western Ontario and McMaster University Arthritis Index scores (
p
= 0.12), the length of hospital stay (
p
= 0.94) and the incidence of nausea and vomiting (
p
= 0.09).
Conclusion
We conclude that the continuous femoral nerve block is more effective than single-shot femoral nerve block after total knee arthroplasty, which provides objective evidence of pain management for anesthetists.</abstract><cop>Cheshire</cop><pub>Springer Healthcare</pub><pmid>31925648</pmid><doi>10.1007/s12325-019-01194-z</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0001-7650-1811</orcidid></addata></record> |
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| subjects | Cardiology Endocrinology Health technology assessment Internal Medicine Medicine Medicine & Public Health Oncology Pharmacology/Toxicology Review Rheumatology |
| title | Analgesic Impact of Single-Shot Versus Continuous Femoral Nerve Block After Total Knee Arthroplasty: A Systematic Review and Meta-Analysis |
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